Laparoscopic supracervical hysterectomy

Divided into palace body, palace bottom, palace corner, cervix. The ratio of the uterus to the cervix varies with age. The uterine cavity is a narrow triangle with a wide upper and lower, with the fallopian tube on both sides and the cervical canal at the tip. The narrowest part between the uterus and the cervix is called the uterine isthmus. It is about 1cm long in non-pregnancy. The upper end is called anatomically narrow because of its anatomical narrowness. The lower end is transformed by the endometrium. For the cervical mucosa, it is called histology. During pregnancy, the uterine isthmus gradually expands and grows, and the end of pregnancy can reach 7 to 10 cm, forming the lower uterus. The cervical cavity is called a cervical canal, and the adult woman is 2.5 to 3.0 cm long. The lower end is called the external cervix. The outer cervix of the unborn woman has a round shape; the external cervix of the mother has formed a transverse split, which is divided into the front lip and the back lip. Treatment of diseases: dysfunctional Indication 1. Adapt to the smooth cervix, normal cytology, young patients need to remove the uterus. 2. The patient is required to retain the cervix. Contraindications 1. Uterine fibroids need to be removed from the uterus. 2. Uterine fibroids, the uterus is less than 4 months pregnant. 3. Uterine adenoma, adenomyosis. 4. Endometrial hyperplasia is too long. 5. Uterine prolapse. Preoperative preparation 1. Preoperative vaginal washing for 3 days. 2. Soap water enema before surgery. 3. Patients with pelvic adhesions need to prepare for bowel. 4. Preoperative catheterization and blood preparation. Surgical procedure 1. Place the device in the supine position or the stone removal position. 2. Uterine vascular treatment with laparoscopic hysterectomy. 3. After the uterine blood vessels were removed, the cervix was ligated 3 times below the plane to be removed from the uterine isthmus, and the cervix was ligated with a ligation method. The stump was cut by electrocoagulation, and the stump was bipolar electrocoagulated with electrocoagulation. The tube should be treated with electrocautery as much as possible. Be careful not to burn the tube. 4. Wash the pelvic cavity and stop bleeding at the bleeding site. 5. The bladder peritoneum is folded back over the cervical stump and the needle is fixed. To prevent cervical prolapse, the round ligament end can be sutured to the cervix. 6. The uterus body was taken out and placed into a large claw forceps through a 10 mm cannula sheath, and the tissue was pulverized by a cylindrical rotary cutter, and the uterus body was pulverized into strips. It is more desirable to use an electric tissue pulverizer. If there is no pulverizer, a small incision can be made on the original puncture hole of the abdominal wall to take out the uterus or take it through the posterior iliac crest. 7. Rinse the abdominal cavity again, aspirate the effusion, vent, take the cannula sheath and the lens, and suture each puncture hole. Postoperative diet 1. Give high protein, high vitamin and cellulose-rich digestible diet. 2, do not eat spicy spicy food.

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