Lee C L, Soong Y K
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Chang Gung Medical School, Linkou Medical Center, Taipei, Taiwan Republic of China.
Int Surg. 1995 Apr-Jun;80(2):167-9.
Laparoscopic hysterectomy has been first reported by Reich et al. in 1989, which confirmed the possibility of laparoscopic hysterectomy being employed as a replacement of the vast majority of traditional abdominal hysterectomies. There are three critical points in laparoscopic hysterectomy. The most important critical point is to identify uterine arteries from the ureter in the paracervical area. Several ureteral injuries at operative laparoscopy have been reported. We performed two hundred and thirty laparoscopic hysterectomies during the period from March 1991 to October 1993. Sixty patients were later included in this study. Thirty of these applied the technique of dissecting the ureter at the initiation of laparoscopic hysterectomy. Most of the patients were discharged on the second postoperative day. Although dissecting the ureter at the beginning of the operation did not produce a significant discrepancy in operation time, blood loss, hospitalization day and ureter injury when compared with the control group, the uterine arteries, however, may be confidently desiccated once the path of the ureter near the uterosacral ligament is identified.
1989年，赖希等人首次报道了腹腔镜子宫切除术，这证实了腹腔镜子宫切除术有可能替代绝大多数传统的腹部子宫切除术。腹腔镜子宫切除术有三个关键点。最重要的关键点是在宫颈旁区域从输尿管中识别出子宫动脉。已有数例腹腔镜手术中输尿管损伤的报道。1991年3月至1993年10月期间，我们进行了230例腹腔镜子宫切除术。后来有60例患者被纳入本研究。其中30例在腹腔镜子宫切除术开始时采用了分离输尿管的技术。大多数患者在术后第二天出院。虽然与对照组相比，手术开始时分离输尿管在手术时间、失血量、住院天数和输尿管损伤方面没有产生显著差异，但是，一旦确定了子宫骶韧带附近输尿管的走行，就可以放心地对子宫动脉进行干燥处理。
