Pelosi M A, Pelosi M A
Department of Obstetrics and Gynecology, Bayonne Hospital, New Jersey, USA.
J Am Assoc Gynecol Laparosc. 1997 Feb;4(2):241-6. doi: 10.1016/s1074-3804(97)80017-5.
We conducted a retrospective review of 21 combined laparovaginal myomectomies to treat extensive and deeply infiltrating fundal and posterior wall leiomyomata. Laparoscopy confirmed the size, number, and position of leiomyomata, permitted intramyometrial vasopressin infiltration, and allowed partial enucleation of large and deep myomata. Posterior colpotomy permitted delivery of myomata and uteri, and uterine reconstruction by conventional suturing performed transvaginally. The uteri were then placed in their anatomic position, the colpotomies were repaired, and a final laparoscopic survey and lavage were performed. All surgeries were successfully completed without intraoperative or postoperative complications. This approach allows a layered traditional uterine reconstruction of deep myometrial defects and may enhance the ability to repair extensive uterine defects in a minimally invasive fashion.
我们对21例联合腹腔镜下阴式子宫肌瘤剔除术进行了回顾性研究，以治疗广泛且深度浸润的子宫底部和后壁平滑肌瘤。腹腔镜检查确定了平滑肌瘤的大小、数量和位置，允许子宫肌层内注射血管加压素，并对大的深部肌瘤进行部分剥除。经阴道后穹窿切开术便于取出肌瘤和子宫，并通过经阴道常规缝合进行子宫重建。然后将子宫放回其解剖位置，修复后穹窿切开术的切口，并进行最后的腹腔镜检查和灌洗。所有手术均成功完成，无术中或术后并发症。这种方法允许对深部子宫肌层缺损进行分层传统子宫重建，并可能提高以微创方式修复广泛子宫缺损的能力。
