阴道后壁分离器在腹腔镜手术经阴道标本取出中的临床应用

Clinical analysis of transvaginal extraction of laparoscopic specimen with posterior vaginal wall separator

关键词:  腹腔镜  阴道切口  阴道后壁分离器  标本取出

Key words:  laparoscopy  vaginal incision  posterior vaginal wall separator  specimens extraction

摘要:

目的 探究在腹腔镜手术时，利用阴道后壁分离器行阴道后壁切开标本取出的安全性及有效性。方法 回顾性分析2017年1月至2018年12月就诊于沈阳市妇婴医院，因子宫肌瘤行腹腔镜下次全子宫切除术的患者64例，所有患者均经阴道后壁切开取出标本，其中使用阴道后壁分离器分离阴道后壁33例，使用纱布卷分离阴道后壁31例。统计并分析两组患者手术时间、阴道壁分离时间、标本取出时间、术中出血量、术中切口并发症、住院天数及切口愈合情况。结果 64例腹腔镜手术均顺利完成，两组患者手术时间、标本取出时间、术中失血量、住院天数、术中切口并发症及手术切口愈合情况均无统计学差异（P>0.05）。但采用阴道后壁分离器组阴道壁分离时间为（375.36±51.68）s，明显少于纱布卷组的（436.55±72.43）s，P<0.05。结论 腹腔镜下使用阴道后壁分离器切开阴道后壁中段，经切口取出标本是一种安全有效的方法，对患者影响小，符合微创原则，便捷有效，易于掌握。

Abstract:

Objective To explore the safety and effectiveness of transvaginal extraction of laparoscopic specimen with posterior vaginal wall separator. Methods A retrospective analysis of 64 patients, who underwent laparoscopic hysterectomy for uterine fibroids in Shenyang Women's and Children's Hospital from January 2017 to December 2018, were performed. All patients received cut through the posterior vaginal wall for specimen extraction. Among them, 33 patients were separated by a vaginal posterior wall separator and 31 patients were separated by a gauze roll. Statistical analysis of operation time, vaginal wall separation time, specimen removal time, intraoperative blood loss, intraoperative incision complications, hospitalization days and incision healing were performed on the two groups of patients. Results Laparoscopic surgeries were successfully completed in all 64 patients. There were no statistical differences in the operation time, specimen removal time, intraoperative blood loss, hospital stay, intraoperative incision complications and surgical incision healing between the two groups (P>0.05). However, the separation time of vaginal wall in the group using posterior vaginal wall separator was shorter than that in the control group (P<0.05). Conclusion Laparoscopic use of posterior vaginal wall separator to cut the middle section of posterior vaginal wall and remove specimen through the incision is a safe and effective method, which has little impact on the patient, conforms to the principle of minimal invasion, and is convenient, effective, and easy to master.