腹腔镜下膀胱阴道瘘修补术 ppt课件

ical surgery?盆腔肿瘤手术损伤 resection of pelvic tumor? ?约75%与全子宫切除术及?盆腔淋巴结清扫术相关Р严重影响患者生活质量?保守治疗一般无效?国内目前多采用开放手术修补?Medically devastating conditions?Conservative Therapy is generally ineffective?Open surgery is more popular domesticР传统手术路径Р腹膜外经膀胱 abdominal transvesical?腹膜外不经膀胱 abdominal extravesical?腹膜外膀胱内外结合 transvesical and ? extravesical?经腹腔 transabdominal Transvesical?经阴道 transvaginalР传统手术的问题Р手术操作难度高:位置深? 空间小?复发率或修补失败率高РLaparoscopic VVF repair attempts to achieve ess rates similar to those of transabdominal repair and avoids the morbidity of open surgeryР单中心5年手术例数 39例РSingle Center Experience 39 casesР腹腔镜下修补手术Р经腹腔路径?Laparoscopic transabdominal transvesical repairР手术准备Р阴道冲洗消毒?肠道准备?全麻?平卧位或截石位?3~4个Trocar?人工CO2气腹Р手术步骤?Surgical ProcedureР建立工作通道Рa three or four-port transabdominal ?approach was used