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[腹腔镜侧方悬吊术,治疗盆腔脏器脱垂的另一种方法]

[Laparoscopic lateral suspension, another way to treat genital prolapse].

作者信息

Dubuisson J B, Veit-Rubin N, Wenger J M, Dubuisson J

机构信息

Clinique La Colline, université de Genève, 1206 Genève, Suisse.

Service de gynécologie-obstétrique, centre hospitalo-universitaire vaudois, 46, rue de Bugnon, 1011 Lausanne, Suisse.

出版信息

Gynecol Obstet Fertil Senol. 2017 Jan;45(1):32-36. doi: 10.1016/j.gofs.2016.12.009. Epub 2017 Jan 17.

Abstract

The laparoscopic sacrocolpopexy is the treatment of choice of pelvic organ prolapses since more than twenty years. The laparoscopic lateral suspension with mesh is an alternative technique. Its originality is the subperitoneal passing of the lateral arm of the mesh in the lateral abdominal wall, leaving the skin above the iliac crest, in a place without risks of vascular, nerve, bowel injuries. We report in this article the results of the three main publications on the subject. The indications are cystocele and apical descent. It can be envisaged when the access of the promontory is difficult; for instance in the presence of obesity, adhesions, sigmoid megacolon, or low position of the left common iliac vein, partially covering the promontory. It is also a practical technique for surgeons having a moderate experience of the promontory access.

摘要

二十多年来,腹腔镜骶骨阴道固定术一直是盆腔器官脱垂的首选治疗方法。腹腔镜网状物侧方悬吊术是一种替代技术。其独特之处在于网状物的侧臂在腹膜下穿过腹壁外侧,使髂嵴上方的皮肤保持完好,处于无血管、神经和肠道损伤风险的位置。我们在本文中报告了关于该主题的三篇主要出版物的结果。其适应症为膀胱膨出和顶端下垂。当难以触及岬部时可考虑采用;例如存在肥胖、粘连、乙状结肠冗长或左髂总静脉位置较低部分覆盖岬部的情况。对于岬部入路经验中等的外科医生来说,这也是一种实用的技术。

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