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10 步搞定子宫内膜异位瘤手术

Surgical Technique for Endometrioma in 10 Steps.

机构信息

Department of Gynaecological Surgery (Drs. Bourdel, Paracchini, Chauvet, Fava, and Canis), CHU Estaing, Clermont-Ferrand, France; Endoscopy and Computer Vision, IP, UMR 6602 Centre National de la Recherche Scientifique (Drs. Bourdel, Chauvet, and Canis), Université Clermont Auvergne, Clermont-Ferrand, France.

Department of Gynaecological Surgery (Drs. Bourdel, Paracchini, Chauvet, Fava, and Canis), CHU Estaing, Clermont-Ferrand, France; Department of Surgical Sciences (Dr. Paracchini), AOU Città della Scienza e della Salute di Torino, Torino, Italy.

出版信息

J Minim Invasive Gynecol. 2020 Feb;27(2):260-261. doi: 10.1016/j.jmig.2019.07.023. Epub 2019 Jul 31.

Abstract

OBJECTIVE

Laparoscopic cystectomy for endometrioma has the advantages of a minimally invasive approach. The standardization and description of the technique are the main objectives of this video. We described the surgery in 10 steps, which could help to make this procedure easier and safer.

DESIGN

Step-by-step video demonstration of the technique.

SETTING

A French university tertiary care hospital.

INTERVENTION

Two standardized laparoscopic cystectomy were recorded to realize the video. The local institutional review board ruled that approval was not required because the video describes a technique and does not report a clinical case. This video presents a systematic approach to cystectomy for endometrioma clearly divided into 10 steps: (1) preoperative evaluation [1]; (2) diagnosis and exploration [2]; (3) adhesiolysis, mobilization of the ovary; (4) cyst rupture, exposition of the entry site; (5) identification of the cleavage plan; (6) endometrioma easy dissection; (7) endometrioma difficult dissection; (8) hemostasis, reconstruction of the ovary [3]; (9) exploration of the ovarian fossa; and (10) washing, extraction of the cyst [3,4].

CONCLUSION

Standardization of laparoscopic cystectomy for endometrioma could make this procedure easier and safer to perform. The 10 steps presented help to perform each part of the surgery in a logical sequence, making the procedure easier to realize. Moreover, the standardization of the surgical techniques may reduce the learning curve.

摘要

目的

腹腔镜卵巢囊肿切除术具有微创的优势。本视频的主要目标是规范和描述该技术。我们将手术步骤分为 10 步进行描述,以帮助手术更容易、更安全。

设计

按步骤演示手术技术。

地点

法国一所大学的三级保健医院。

干预措施

记录了两次标准化腹腔镜囊肿切除术,以制作该视频。当地机构审查委员会裁定,由于该视频仅描述了一种技术,并未报告临床病例,因此不需要批准。本视频提出了一种系统的方法,将卵巢子宫内膜异位囊肿切除术清晰地分为 10 个步骤:(1)术前评估[1];(2)诊断和探查[2];(3)粘连松解,卵巢游离;(4)囊肿破裂,显露进入点;(5)确定分离平面;(6)易分离的子宫内膜异位囊肿;(7)难分离的子宫内膜异位囊肿;(8)止血,卵巢重建[3];(9)探查卵巢窝;(10)冲洗,取出囊肿[3,4]。

结论

腹腔镜卵巢子宫内膜异位囊肿切除术的标准化可以使手术更容易、更安全。呈现的 10 个步骤有助于按照逻辑顺序完成手术的每一部分,使手术更容易实现。此外,手术技术的标准化可能会减少学习曲线。

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