Wallwiener D, Rimbach S, Aydeniz B, Pape M, Posten J, Motazedi D, von Fournier D, Bastert G
Universitäts-Frauenklinik Heidelberg.
Zentralbl Gynakol. 1994;116(11):599-608.
Hysteroscopy has become an integral part of the overall gynaecological surgical concept. On the one hand the experience of our study group as well as a literature survey have demonstrated that results of hysteroscopic metroplasty, resection of submucous myoma and synechiolysis are at least comparable to those of conventional procedures, the advantages of minimal invasive surgery being evident. However, increasing complications, even with a lethal outcome, due to deficient technical equipment or insufficient training of the surgeon are reported. Yet, a survey of complications in literature and in our own series of hysteroscopies (n = 200), shows a median complication rate below 1%. Knowledge of possible complications, symptoms and management alternatives is, however, a first requirement for application of these minimal access procedures. The second major precondition being a well structured training program for surgeon and assisting team. With the recently developed in-vitro-simulation trainer, the HysteroTrainer, training of the entire spectrum of hysteroscopic procedures, including laser and high frequency electrosurgical applications, is now feasible. The simulator may also be employed for security checking of the complex hysteroscopic equipment.
宫腔镜检查已成为整个妇科手术理念中不可或缺的一部分。一方面，我们研究小组的经验以及文献调查表明，宫腔镜子宫成形术、黏膜下肌瘤切除术和粘连松解术的结果至少与传统手术相当，微创手术的优势显而易见。然而，有报道称，由于技术设备不足或外科医生培训不足，并发症不断增加，甚至出现致命后果。不过，对文献和我们自己的200例宫腔镜检查系列中的并发症进行调查显示，并发症的中位数发生率低于1%。然而，了解可能的并发症、症状及处理方法是应用这些微创手术的首要条件。第二个主要前提是为外科医生和辅助团队制定完善的培训计划。借助最近开发的体外模拟训练器HysteroTrainer，现在可以对包括激光和高频电外科应用在内的全系列宫腔镜手术进行培训。该模拟器还可用于对复杂的宫腔镜设备进行安全检查。
