Gordts S, Campo R, Rombauts L, Brosens I
Leuven Institute for Fertility and Embryology, Belgium.
Hum Reprod. 1998 Jan;13(1):99-103. doi: 10.1093/humrep/13.1.99.
A new technique called transvaginal hydrolaparoscopy is described for the exploration of the tubo-ovarian structures in infertile patients without obvious pelvic pathology. It aims to be an acceptable alternative to diagnostic laparoscopy, a standard but not innocuous procedure which infrequently reveals pathology in the asymptomatic patient. Transvaginal hydrolaparoscopy copy is performed under local anaesthesia using a small diameter optic with the patient in the dorsal position. Cavity distension is achieved with normal saline. Transvaginal hydrolaparoscopy does not provide the familiar and panoramic view of the pelvis given by laparoscopy, but it does have several advantages. These include accurate and atraumatic inspection of adnexal structures without manipulation, with the opportunity to perform dye hydrotubation and salpingoscopy. The risks of a general anaesthetic are avoided, and there is less risk of trauma to major vessels. The high patient acceptability makes transvaginal hydrolaparoscopy suitable as an early stage procedure in the investigation of infertility and as a repeat or second look procedure. Minor operative procedures such as biopsy and adhesiolysis can also be performed. In patients with obvious pelvic pathology, diagnostic laparoscopy will obviously remain the procedure of choice. Transvaginal hydrolaparoscopy deserves full evaluation of its accuracy, risks and benefits before it can be accepted as a new first line technique in gynaecological practice.
一种名为经阴道水腹腔镜检查的新技术被用于探索无明显盆腔病变的不孕患者的输卵管卵巢结构。它旨在成为诊断性腹腔镜检查的一种可接受的替代方法，诊断性腹腔镜检查是一种标准但并非无害的程序，在无症状患者中很少发现病变。经阴道水腹腔镜检查在局部麻醉下进行，使用小直径的内镜，患者取仰卧位。用生理盐水使盆腔扩张。经阴道水腹腔镜检查无法提供腹腔镜检查所熟悉的盆腔全景视图，但它确实有几个优点。这些优点包括在不进行操作的情况下对附件结构进行准确且无创伤的检查，并有机会进行输卵管通液和输卵管镜检查。避免了全身麻醉的风险，对主要血管的创伤风险也较小。患者的高接受度使经阴道水腹腔镜检查适合作为不孕症调查的早期程序以及重复或二次检查程序。还可以进行活检和粘连松解等小手术。对于有明显盆腔病变的患者，诊断性腹腔镜检查显然仍是首选程序。在经阴道水腹腔镜检查被接受为妇科实践中的一种新的一线技术之前，值得对其准确性、风险和益处进行全面评估。
