Shepherd Jonathan P, Zyczynski Halina M
Department of Obstetrics, Division of Urogynecology and Reconstructive Pelvic Surgery, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, Pittsburgh, Pennsylvania, USA.
Clin Obstet Gynecol. 2010 Mar;53(1):17-25. doi: 10.1097/GRF.0b013e3181ce87fc.
Removal of the fallopian tubes and ovaries at the time of vaginal hysterectomy is a skill that must be acquired if one is to be a competent vaginal surgeon. Various techniques have been described and will be reviewed in this chapter. A single technique or series of steps often must be modified depending on the descent of the adnexa, size and shape of the pelvis, and intraperitoneal pathology. The pelvic surgeon must adhere to the basic surgical principles and understand the anatomic relationships of the adnexa to other pelvic viscera, including the lower urinary tract. Preoperative discussion with all patients regardless of age is imperative in determining their desires for oophorectomy at the time of vaginal hysterectomy.
如果想要成为一名合格的阴道外科医生，在进行阴道子宫切除术时切除输卵管和卵巢是一项必须掌握的技能。已经描述了各种技术，本章将对其进行回顾。通常必须根据附件的下垂情况、骨盆的大小和形状以及腹膜内病变对单一技术或一系列步骤进行修改。盆腔外科医生必须坚持基本的外科原则，并了解附件与其他盆腔脏器（包括下尿路）的解剖关系。无论患者年龄大小，术前与所有患者进行讨论对于确定他们在阴道子宫切除术时是否希望进行卵巢切除术至关重要。
