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腹腔镜间质部妊娠宫角切除术:保留在边缘区

Laparoscopic cornual resection for interstitial pregnancy: Staying in the Marginal Zone.

作者信息

Kathopoulis N, Kypriotis K, Douligeris A, Zacharakis D, Prodromidou A, Chatzipapas I, Grigoriadis T, Protopapas A

出版信息

Facts Views Vis Obgyn. 2024 Sep;16(3):355-358. doi: 10.52054/FVVO.16.3.032.

Abstract

BACKGROUND

Fortunately, interstitial pregnancies are a rare early pregnancy presentation, yet they can be challenging to managed and are associated with a high risk of intra-abdominal haemorrhage. Once detected, surgical laparoscopic resection can be the preferred management method for both patient safety and for definitive treatment.

OBJECTIVE

The video presents a new technique for laparoscopic resection of an interstitial pregnancy which enables the procedure to be effectively bloodless.

MATERIALS AND METHODS

We report on a new technique for laparoscopic cornual resection. As shown in the video, staying in the marginal zone may result in the enblock resection of the gestational sac. Using meticulous applications of bipolar energy and cutting with scissors in the marginal zone, the operation may be completed with almost no blood loss and minimal damage to the adjacent healthy myometrium.

RESULTS

The operation lasted 30 min with almost no blood loss. The patient had an uneventful recovery and was discharged on the first postoperative day.

CONCLUSIONS

Staying in the marginal zone during dissection permits even less experienced laparoscopists to complete laparoscopic cornual resection with minimal blood loss concomitantly with minimal trauma to the adjacent myometrium.

摘要

背景

幸运的是,间质部妊娠是一种罕见的早期妊娠表现,但处理起来具有挑战性,且与腹腔内出血的高风险相关。一旦确诊,为了患者安全和进行确定性治疗,腹腔镜手术切除可能是首选的治疗方法。

目的

本视频展示了一种腹腔镜切除间质部妊娠的新技术,该技术能使手术有效做到无血操作。

材料与方法

我们报告一种腹腔镜子宫角切除术的新技术。如视频所示,停留在边缘区域可能会整块切除妊娠囊。在边缘区域精细应用双极能量并使用剪刀进行切割,手术几乎可以在不出血且对相邻健康肌层损伤最小的情况下完成。

结果

手术持续30分钟,几乎无出血。患者恢复顺利,术后第一天出院。

结论

在解剖过程中停留在边缘区域,即使经验较少的腹腔镜手术医生也能以最少的出血量和对相邻肌层最小的创伤完成腹腔镜子宫角切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d59/11569432/d71e7d166bce/FVVinObGyn-16-355-g001.jpg

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