Quesnel-García Benítez Carlos, Avilés-Cabrera Ricardo Nicolás
División de Ginecología y Obstetricia, Hospital Angeles Lomas, Huixquilucan, Edo. de México.
Ginecol Obstet Mex. 2010 Apr;78(4):238-44.
Gynecologic surgery often entails meticulous dissection in areas close to the bladder, rectum, ureters and major vessels of the pelvis. The close anatomical relationship between these bodies that frequently makes are affected during pelvic surgery. When a complication occurs, it is vital to recognize and treat appropriately, emphasizing that gynecologists should handle its own complications and when they exceed the capacities of their own specialty, as in the case of unusual or complex lesions, should be sent assistance of a colleague in another specialty to solve the problem. To avoid intraoperative or injury is very important to timely diagnose an adequate knowledge of anatomy, surgical techniques using methodical and meticulous, with delicate sharp dissection and manipulation of tissues with a high index of suspicion constant in addition to routine cystoscopy after surgery to rule out injury. Once diagnosed the injury, repairing it at primary surgery is usually easier, successful and results in less morbidity.
妇科手术常常需要在靠近膀胱、直肠、输尿管以及盆腔主要血管的区域进行细致的解剖。这些器官之间紧密的解剖关系使得它们在盆腔手术中经常受到影响。当并发症发生时,正确识别并进行恰当治疗至关重要,这强调了妇科医生应处理自身的并发症,而当超出其自身专业能力范围时,比如遇到不寻常或复杂的病变,应寻求其他专科同事的协助来解决问题。为避免术中损伤,及时诊断并充分了解解剖结构、采用有条不紊且细致的手术技术、进行精细的锐性解剖以及对组织进行轻柔操作,并始终保持高度的怀疑指数,同时术后常规进行膀胱镜检查以排除损伤,这些都非常重要。一旦诊断出损伤,在初次手术时进行修复通常更容易成功,且发病率更低。