Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China..
J Minim Invasive Gynecol. 2019 Jan;26(1):169-174. doi: 10.1016/j.jmig.2018.05.013. Epub 2018 May 23.
Natural orifice transluminal endoscopic surgery (NOTES) is a relatively new technique currently being studied around the world. Between June 2015 and June 2017, 12 patients diagnosed with ectopic pregnancy underwent transvaginal NOTES to remove their fallopian tubes. All 12 surgeries were completed successfully. The median age of patients was 33years (range, 28-42), and the median body mass index was 23.47 (range, 20.55-27.68). The median duration of amenorrhea was 53days (range, 41-60). The median serum β-human chorionic gonadotropin was 8887 U/mL (range, 392-25 695). The median ectopic mass longest diameter was 2.95 cm (range, 2.1-5.0). The median surgical time was 47.5 minutes (range, 40-70). The median hemoperitoneum was 52.5 mL (range, 20-300), and the median blood loss was 7.5 mL (range, 2-20). Our study has proven the feasibility and repeatability of transvaginal NOTES for less difficult ectopic pregnancies. The success of transvaginal NOTES lies in the choice of patients and the establishment of the transvaginal operating platform. We added a plastic ring between the inner and outer rings outside the wound retractor. The modified platform can lessen the technical difficulties of performing transvaginal NOTES and broaden its applicability to other procedures.
经自然腔道内镜手术（NOTES）是一种相对较新的技术，目前正在全球范围内进行研究。在 2015 年 6 月至 2017 年 6 月期间，有 12 名异位妊娠患者接受了经阴道 NOTES 输卵管切除术。所有 12 例手术均顺利完成。患者的中位年龄为 33 岁（范围 28-42 岁），中位体重指数为 23.47（范围 20.55-27.68）。中位闭经时间为 53 天（范围 41-60 天）。中位血清β-人绒毛膜促性腺激素为 8887 U/ml（范围 392-25695）。异位肿块最长直径的中位数为 2.95cm（范围 2.1-5.0cm）。中位手术时间为 47.5 分钟（范围 40-70 分钟）。中位腹腔积血量为 52.5ml（范围 20-300ml），中位出血量为 7.5ml（范围 2-20ml）。我们的研究证明了经阴道 NOTES 治疗较简单异位妊娠的可行性和可重复性。经阴道 NOTES 的成功取决于患者的选择和经阴道手术平台的建立。我们在伤口牵开器的外环与内环之间增加了一个塑料环。改良的平台可以减少经阴道 NOTES 的技术难度，并扩大其在其他手术中的适用性。
