Department of Obstetrics and Gynaecology, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, QC.
Department of Obstetrics and Gynaecology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC.
J Obstet Gynaecol Can. 2020 Jun;42(6):802. doi: 10.1016/j.jogc.2019.11.005. Epub 2020 Mar 11.
A 38-year-old woman was referred to our centre for symptomatic leiomyoma. The patient had a large uterus, heavy menstrual bleeding, and compressive symptoms refractory to medical treatments. The patient was then scheduled for total laparoscopic hysterectomy with contained morcellation. After circular colpotomy completion, a strong, folded, 4-L bag with an additional sleeve for the optics was inserted into the abdominal cavity through the vagina. The colored tabs on the edge of the bag mouth served as landmarks during bag deployment. After ensuring optimal positioning, the entire bag was fully deployed, and the specimen was placed inside. Thereafter, the coloured tabs were joined together, and a monofilament drawstring was cinched to close the bag and pulled out through the suprapubic trocar. Next, the small extra sleeve was brought up through the umbilical incision. The bag was then insufflated, and the power morcellator was inserted through the suprapubic incision. After completing the morcellation, the pneumo bag was evacuated, and knots were made in both openings of the bag to avoid spillage. The closed bag was finally removed through the vagina, with final laparoscopic closure of the vaginal vault.
一位 38 岁的女性因有症状的子宫肌瘤而被转介至我们中心。该患者子宫较大，月经过多且有压迫症状，经药物治疗无效。随后，患者接受了全腹腔镜子宫切除术，并进行了封闭性子宫切除术。完成环形阴道切开术后，通过阴道将一个带有附加光学套管的强力折叠 4-L 袋插入腹腔。袋子边缘的彩色标签可作为袋子展开时的标记。确保袋子定位良好后，将整个袋子完全展开，将标本放入其中。然后，将彩色标签连接在一起，并系紧单丝拉绳以关闭袋子，并通过耻骨上 trocar 取出。接下来，将小的附加套管通过脐部切口提起。然后给袋子充气，并通过耻骨上切口插入电动组织切碎器。完成切碎后，排空充气袋，并在袋子的两个开口处打结以防止溢出。最后通过阴道取出封闭的袋子，最后通过腹腔镜完成阴道穹窿的关闭。
