改良式腹腔镜辅助下阴式子宫切除术5例

目的介绍改良式腹腔镜辅助下阴式子宫切除术。方法在LAVH-I型的基础上结合部分Ⅲ型,即在镜下离断双侧圆韧带、输卵管、卵巢固有韧带（或卵巢悬韧带）,打通阴道后穹窿,并离断双侧骶韧带;经阴道处理主韧带及子宫血管。结果5例患者全部成功实施改良式腹腔镜辅助下阴式子宫切除,手术时间90～150 min,平均110 min,术中出血80～250 mL,平均165 mL,无1例大出血、副损伤及术后病率。结论改良式腹腔镜辅助下阴式子宫切除术既克服了开腹手术和阴式手术的缺陷,降低手术难度,缩短手术时间,减少术中出血,特别适合初学者和基层医院开展,是子宫切除方式的又一术式选择。

Modified laparoscopic assisted vaginal hysterectomy in 5 cases

Objective：To introduce the modified laparoscopic-assisted vaginal hysterectomy. Methods： Based on LAVH-1-type, 5 cases were treated with Modified laparoscopic assisted vaginal hysterectomy which was based on Levh-1-type and combined with Ⅲ type. Results： All operation were successful, the operative time was from 90 min to 150 min, the average was 110 min, the intraoperative blood loss was 80-250 mL （mean, 165 mL）. No one developed hemorrhage and other side effect. Conclusion： Modified laparoscopicassisted vaginal hysterectomy could overcome the defects of laparotomy and vaginal surgery, reduce the operation difficulty, shorten the operation time and reduce bleeding.