为了正常的体验网站,请在浏览器设置里面开启Javascript功能!

微创手术在妇产科的运用

2011-06-18 34页 pdf 602KB 19阅读

用户头像

is_249380

暂无简介

举报
微创手术在妇产科的运用 微創手術在婦產科的運用 Introduction • 1807 Bozzini: a candle light conductor • 1880 Nitze developed the cystoscope • 1901 Kelling : celioscope examination of a living dog after pneumoperitoneum • 1901 Jacobaeus: laparoscopy by direct insertion of a Nitze cystoscope ...
微创手术在妇产科的运用
微創手術在婦產科的運用 Introduction • 1807 Bozzini: a candle light conductor • 1880 Nitze developed the cystoscope • 1901 Kelling : celioscope examination of a living dog after pneumoperitoneum • 1901 Jacobaeus: laparoscopy by direct insertion of a Nitze cystoscope • 1938 Veress: a new needle for inducing pneumothorax for the treatment of TB for pneumoperitoneum. Introduction • 1937 the first gynecologic report was published by Hope on the use of the laparoscope for diagnosis of tubal pregnancy • 1941 Power and Barnes : for tubal sterilization • 1952 : cold light History • 1952: Fiberoptics • 1972 American Association of Gynecologic Lparoscopists was formed 1987-1992 residents should document their training in gynecologic endoscopic procedure. Introduction • 1973年台大醫學院黃國恩教授使用內生殖鏡輸卵 管節育法替病人結紮。 • 1975年馬偕醫院蔡明賢醫師使用開放式腹腔鏡術 做診斷。 • 1977年中興醫院林水盛、張中全做子宮外孕的腹 腔鏡診斷,減少錯誤診斷及不必要的剖腹手術。 • 真正開始手術性腹腔鏡是由劉宗元、歐朝士兩位 教授於1991至1993年前後六次回國教授內視鏡手 術 Benefit • Reduce peritoneal trauma • Reduce contamination of the peritoneal cavity • Less adhesion • Shortened stay • Small wound Potential limitation • Operative field can be reduced • Difficult suture • Prolonged operating room time • More expensive surgical equipment • Surgical expertise • With an adequate combination of ability, training and experience, operative time and complications are comparable to those of traditional abdominal surgery WHO suggest • Sterilization • Ectopic surgery • Diagnostic Tubal surgery • Sterilization: • Since 1960s • Suture, clips, silastic rings • Electrosurgical desiccation with bipolar energy • Failure rate: 5.4/1000 Ectopic pregnancy • Laparoscopic salpingostomy, • Laparoscopic salpingectomy • Laparoscopic segmental resection of a portion of the oviduct Ovarian surgery • Ovarian masses: • Removal of the selected ovarian masses • Preoperative ultrasonography • Sonolucent, thin wall, no solid components • CA 125 • Mature teratoma • Ovarian torsion • Through laparoscopic cannula and posterior colostomy Use retrieval bag Endomtriosis • Recent finding: • Large, long term, prospective studie and placebo controlled, randomized, controlled trial suggest laparoscopic excision is an effective treatment approach for patients with all stages of endomtriosis. Uterine surgery • Hyeterectomy • Total laparoscopic hysterectomy (TLH) • Subtotal laparoscopic hysterectomy (SLH) • Vaginally assisted laparoscopic hysterectomy (VALH) • Laparoscopically assisted vaginal hysterectomy Laparoscopic myomectomy • Menorrhagia and anemia • Pelvic pain and pressure • Enlarging leiomyoma and possibility of neoplasia • Associated fetal wastage or infertility • Gestational size more than 12 wks • Obstructed ureter The Role of laparoscopy in the management of gynecologic malignancy • Ovarian cancer • Cervical cancer • Endometrial cancer --- favored Laparoscopy in endometrial cancer • Surgical staging • Early stage • Cell type: exclude clear cell and papillary serous cell • Pelvic lymph node sampling Hysteroscope • Diagnostic hysteroscope • Operative hysteroscopy • Trascervical resection of submucosal uterine myoma • Endometrial ablation of endometrium • Synechiae Conclusion • 約80%的婦科手術可以用腹腔鏡完成 • 微創手術已成為主流 Thank you 微創手術在婦產科的運用 Introduction Introduction History Introduction Benefit Potential limitation WHO suggest Tubal surgery Ectopic pregnancy Ovarian surgery Use retrieval bag þÿ þÿ þÿ þÿ þÿ þÿ þÿ þÿ Endomtriosis Uterine surgery þÿ þÿ Laparoscopic myomectomy þÿ þÿ The Role of laparoscopy in the management of gynecologic malignancy þÿ Laparoscopy in endometrial cancer Hysteroscope þÿ Conclusion Thank you
/
本文档为【微创手术在妇产科的运用】,请使用软件OFFICE或WPS软件打开。作品中的文字与图均可以修改和编辑, 图片更改请在作品中右键图片并更换,文字修改请直接点击文字进行修改,也可以新增和删除文档中的内容。
[版权声明] 本站所有资料为用户分享产生,若发现您的权利被侵害,请联系客服邮件isharekefu@iask.cn,我们尽快处理。 本作品所展示的图片、画像、字体、音乐的版权可能需版权方额外授权,请谨慎使用。 网站提供的党政主题相关内容(国旗、国徽、党徽..)目的在于配合国家政策宣传,仅限个人学习分享使用,禁止用于任何广告和商用目的。

历史搜索

    清空历史搜索