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How to choose gynecological minimally invasive surgery

- Jul 13, 2018 -

Minimally invasive premises

Minimally invasive, generally refers to small trauma, less bleeding, less pain, and quick recovery. In this connection, it is itself the basic concept of surgery and the principle of observance. If you want to achieve minimally invasive, the key is to choose the surgical approach and surgical approach. For example, gynecological surgery has three types of human laparotomy, transvaginal and endoscopic. For some diseases, there are three possible pathways to choose from, but for other diseases, it may not be suitable or difficult to use some way. The choice of surgical approach and method is particularly important.

Choosing a path – In addition to making decisions, the path is the first step in surgery and best reflects the concept of minimally invasive surgery. It can usually be considered that the impact on the body, from small to large, is transvaginal - endoscopy - open. For example, if the hysterectomy is not very large, if it can be removed from the vagina, it is not necessary to open the abdomen, or even without laparoscopic assistance. Laparoscopically assisted hysterectomy can be performed to deal with more difficult attachment problems. A very large uterus is best for laparotomy. Of course, the surgical approach should be individualized, first considering transvaginal, then endoscopy, and finally open surgery.

The choice of surgery - surgery for the purpose of resection of the disease, but not the larger the scope of resection, the wider the better. A typical example is surgery for vulvar cancer. Traditional extensive vulvar resection and double inguinal lymph node resection, forming a "big butterfly"-like incision and wound, large damage, delayed healing is very common. After the improvement of the "three incisions", and in the removal of the inguinal lymph nodes, mainly focused on the shallow part of the femoral triangle, if the sentinel lymph node is negative, do not expand the operation, do not do pelvic lymph node resection, reduce the damage, and achieved better results.

The concept of minimally invasive surgery runs through the surgery. It is reflected in the cutting and sewing, one stroke and one stroke. When performing microsurgery or endoscopic surgery, we often mention several technical principles, such as keeping wet, keeping blood free, keeping it clear, keeping it soft, and maintaining speed, which is simply to keep it minimally invasive. Therefore, these technical principles are also suitable for any surgical procedure.

Minimally invasive category

Since minimally invasive is a concept and a principle, it is difficult to define what is minimally invasive and what is a great creation, but it is still possible to roughly divide some categories.

Transvaginal surgery - In addition to the surgery of the vagina itself, other pelvic surgeries, if performed from the vagina, can be performed from the vagina as a minimally invasive principle. Today, transvaginal surgery can be completed: 1. Hysterectomy, less than 10 weeks of pregnancy is appropriate; combined with attachment mass or can not exclude malignant is not appropriate. 2. Uterine fibroids are removed, and the single posterior wall of the posterior wall is suitable. 3. Tubal sterilization is very convenient. 4. Operation of pelvic organ prolapse and stress urinary incontinence. 5. Gynecologic oncology surgery, the most challenging for cervical cancer surgery. From the vaginal extensive hysterectomy for more than 100 years, due to the concept of renewal and the application of laparoscopic surgery, uterine radical resection of the uterus and laparoscopic assisted transvaginal hysterectomy and pelvic lymphadenectomy for cervical cancer There are new ideas and techniques in the operation.



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