新技术：手助腹腔镜在妇科手术中的应用经验分析

中国医学科学院 中国协和医科大学 北京协和医院 北京100730                          

孙爱军   甄璟然  钟森  

 【摘要】目的：探讨手助腹腔镜在妇科手术中的应用。方法  回顾性分析我院2003年4月至2005年7月间23例手助腹腔镜的治疗经验。对实施手助腹腔镜的各种情况如疾病种类、手术适应征、术中出血情况、手术时间、术后恢复与近期与远期并发症等进行分析。结果  23例手术中，22例成功完成，1例改为开腹手术。大部分病例为盆腔严重粘连，通常需要改为开腹手术患者。术中平均出血量63±45.3 (20--200) ml,手术时间平均分钟89.1±25.6（45--180）分钟，术中术后均无严重并发症发生。术后患者疼痛轻微，恢复快，术后平均住院时间为4.05±1.7(1--7)天。术后随诊3～30月，无远期并发症发生。结论 运用手助腹腔镜技术可以综合开腹手术和腹腔镜手术的优势，达到微创的目的。

【关键词】腹腔镜手术  盆腔粘连  手助

Analysis of the application of hand-assisted laparoscopic surgery in gynecologic operation  

SUN Ai-jun,CHEN Ying , DING Xi-lai, GAO Jing-song,LIU Hai-yuan,HE Fang-fang. Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Science,Beijing 100730,China 【Abstract】Objective  To explore the value of hand-assited laparoscopic surgery in gynecology. Methods  Data of 23 cases who took hand-assisted  laparoscopic surgery in complicated gynecological operation from 2003 to 2005 were analyzed retrospectively. The parameters related to the operatin such as, sorts of diseases, the indication of operation, bleeding and the complication were collected and analyzed.  Result  The duration of operation  was from 45 to 180 minute (average89.1±25.6 min) ,the amount of blood loss was from 20 ml to 200 ml（average 63±45.3）. All patients had uneventful courses with less pain, faster recovery. The hospitalized duration was 4.05±1.7(1—7days). The patients were followed up for 3 to 30 month and no complications were found.   Conclusion  The hand-assisted laparoscopic approach made better use of the advantages of both laparectomy and laparoscopic surgery and bypassing their weakness, achieving the goal of minimally invasive surgery.

Key word: laparoscopy  adhension   hand-assisted

手助腹腔镜手术（Hand-assisted Laparoscopi Surgery,HALS）是国际上近年来发展起来的一项新技术，已在多种外科手术中得到应用，手助式腹腔镜术可保留腹腔镜微创手术的优势，并可降低腹腔镜手术的难度和风险，更具灵活性。目前尚未见应用于妇科手术的报道。我院于2003年4月至2005年7月间应用手助腹腔镜手术23例，取得了较好的疗效，现报道如下，以探讨其应用于妇科手术领域中的临床意义。

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