Ovariotomy and Ovarian Cystectomy

Treating diseases: ovarian cysts Indication 1. Women in the reproductive period, the diameter of the ovarian cyst is greater than 5cm, and it is required to retain fertility. 2. Ovarian cysts destroy normal ovarian function or cannot be stripped. 3. Patients with breast malignant tumors need to undergo ovarian castration surgery. 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. 2. Routine collection of peritoneal fluid or irrigation fluid for cytology. 3. Expose the ovaries to the 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. 4. 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 the puncture, the liquid is sucked out. After the needle is pulled out, the puncture hole is clamped by the separation pliers. The wall of the capsule tightens the ferrule to prevent leakage of the remaining cyst fluid. 5. Treatment of the oviduct mesate with electrocoagulation forceps and clamped electrocoagulation membranes one by one. 6. Treatment of the funnel ligament, intrinsic ligament: (1) ferrule ligation: If the ovary intrinsic ligament and funnel ligament are slack, you can use a ferrule to cut three times and then cut it. (2) Electrocoagulation method: electrocoagulation funnel ligament, intrinsic ligament, and shearing with bipolar coagulation or monopolar electrocoagulation forceps. (3) Sewing method: use a needle holder to enter the suture two ligaments, and respectively ligature and cut. 7. Take out the specimen: Because the ovary and cyst are not large or have been sucked out, it is generally easy to remove from the cannula or puncture hole. If it is too large, the specimen bag can be loaded first and then closed, and then separated from the taken bag mouth. Remove the specimen.

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