ovarian cyst removal

Treating diseases: ovarian cysts Indication 1. Ovarian cysts are small and require fertility preservation. 2. The normal part of the affected ovary is not damaged. 3. Ovarian crown cysts. Contraindications 1. Severe cardiovascular disease, pulmonary insufficiency. 2. Diffuse peritonitis. 3. Umbilical hernia, hernia, abdominal wall hernia, inguinal hernia or femoral hernia. 4. Coagulation is abnormal. 5. Due to the history of surgery, extensive scarring of the abdominal wall or extensive adhesions in the abdominal cavity. 6. Excessive obesity. Preoperative preparation 1. Preparation of the skin of the abdomen and vulva (including the cleaning of the umbilicus). 2. Intestine preparation 0.1% soapy water enema before the night before surgery. If it is possible to involve the operation of the intestine, 3 days of bowel preparation is performed before surgery. 3. Preoperative medication, such as a large range of surgery, may involve the intestines, antibiotics should be used to prevent infection 3 days before surgery. Sedative, atropine or scopolamine was injected 30 min before surgery. 4. Indwell the catheter. 5. Prepare blood or prepare for autologous blood transfusion. Surgical procedure 1. Head low-foot high supine position, routine three-point puncture, mirroring and exploration, pay attention to the affected side of the ovary with or without adhesion and contralateral ovary, uterus. Routine collection of peritoneal fluid or irrigation fluid for cytology. Expose the ovary in front of the uterus. It is usually necessary to use the probe rod along the inner side of the ovary, and the ovaries and cysts are carefully placed outwardly from the posterior lobe of the broad ligament, so that the uterus naturally sinks to the rear, so that the ovary is located in front of the uterus for easy operation. If the cyst is larger than 10cm, it is usually necessary to first place a set of rings on the puncture site, and then use a long needle to connect the suction tube. After piercing, the liquid is sucked out. After the needle is pulled out, the puncture hole is clamped to lift the wall. , tighten the ferrule to prevent leakage of the remaining cyst fluid. 2. Incision of the surface of the cyst The normal ovary usually needs to avoid the vascular area. The surface capsule of the cyst is separated by water injection method, or after electrocoagulation or directly cut open. Generally, a small opening is cut first, and the curved surface is curved upwards or outwards. , cut one by one according to the gap and cut it. After more than half a week, the surgeon and the assistant each hold a separate forceps, respectively clamp the side edge, tear the cyst surface capsule in the opposite direction, and generally can completely remove the cyst. After the cut for more than half a week, the probe can be used to separate the cyst from the normal ovarian tissue. When the dichotomy is broken, the incision can be enlarged by scissors, and the cyst can be completely removed. 3. Residual ovarian wound hemostasis to treat active bleeding of the wound with bipolar or unipolar coagulation. 4. Trim the excess envelope tissue to shape the remaining normal ovaries. After the electrocoagulation is clamped by the bipolar electrocoagulation forceps, the tissue will contract to the center, the wound surface will be reduced, and the suture will not be sutured. After the adhesion. The eschar membrane caused by electrocoagulation is beneficial for preventing adhesion after surgery. 5. Flush the pelvis sufficiently to check for active bleeding. 6. Other steps are the same as before.

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