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Endoscopic surgery

- Jul 16, 2018 -

Endoscopic surgery - Endoscopic surgery is gradually becoming the basic model of gynecological surgery.

Laparoscopic surgery: 1. Laparoscopy is a well-defined surgery, including gynecological acute abdomen, pelvic mass or ovarian benign cyst diagnosis and treatment, endometriosis laparoscopic examination and surgery. 2. Optional laparoscopic surgery, mainly hysterectomy, uterine fibroids removal, tubal anastomosis and peritoneal artificial vaginoplasty, ovarian benign tumors during pregnancy, endometrial cancer surgery, radical resection of cervical cancer, pelvic floor Reconstruction and so on. Application of hysteroscopic surgery: endocervical resection (for abnormal uterine bleeding), polypectomy, etc., there are now endometrial removal systems for new energy such as microsurgical images, hot balls, and fallopian tubes developed by sinus surgery Microscopic examination and operation. In addition, there are minimally invasive techniques such as ultrasound intervention, radiation intervention and high-energy ultrasound focusing therapy. Some new energy systems have also been used in gynaecological surgery, with traditional knife-cutting pliers. Conventional weapons complement each other, such as radiofrequency ablation, hydroquinone, ultrasonic scalpels, and vascular closure systems.

Minimally invasive indication

Since minimally invasive is a concept, a principle, when applied to any surgery. However, the emphasis here is on selecting the target of surgery and the operator to achieve the goal of minimally invasive. The choice of indications is actually four elements, that is, the patient and its disease, the surgeon and its operation. These four items must be fully matched to be a good choice, otherwise the choice should be changed or adjusted. For example, the treatment of a disease is not suitable for this type of surgery, and even if it is not suitable for this surgeon, it should be changed, or it should be more suitable for the surgeon of this procedure, and should not be forced to do so. No surgical technique or surgeon should show off surgery as a technique or device.

Complications can occur in any operation, and minimally invasive surgery should avoid and reduce complications of gynecological diseases. It is worth noting that minimally invasive surgery has “dangerous” factors that cause complications: 1. The space for vaginal surgery is narrow, the exposure is difficult, the operation is limited, the urethra, bladder, rectum are adjacent to each other, the pelvic high or the mass is too large. Increase the difficulty. 2. The observation of the endoscope belongs to the two-dimensional space, and the field of vision is limited. The robot "completes the operation and lacks the touch feeling. 3. The operation of various system energy is actually the source of the damage. 4. The damage caused by vaginal or endoscopic surgery, such as bleeding or organ damage, is difficult and has It is a passive and thorny problem that cannot be detected in time. 5. Special concurrency problems such as air embolism, fluid overload and dilute hyponatremia (such as TURP syndrome) are sometimes fatal.

Therefore, the implementation of these procedures should not be worse than the open or equivalent, should be better and safer, otherwise "minimally invasive" can become "Gianchuang." A mature gynaecologist should master all kinds of surgical methods and be good at forming his own strengths.



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