pelvic adhesion dissection

Pelvic adhesion separation is generally the removal of pelvic adhesions under laparoscopy. Treatment of diseases: intestinal endometriosis endometriosis Indication Laparoscopic pelvic adhesion lysis is suitable for inflammation and endometriosis with pelvic wall, intestinal tract, and omentum. Contraindications Older, combined with severe heart, liver, kidney and other diseases and difficult to tolerate surgery. Preoperative preparation It should be 3-7 days after menstruation is clean. You can be admitted to the hospital 1 day after the menstruation is clean, because you need to prepare for 2-3 days before surgery, such as blood test type, ECG and so on. Surgical procedure In the course of surgery, b-ultrasound or laparoscopic monitoring is used to ensure the safety of the operation and prevent the formation of pelvic perforation and false tract. Laparoscopic in vivo ultrasound has been reported to be used to monitor cases of severe pelvic adhesions and complete pelvic obstruction. It combines the upper hand of laparoscopic and ultrasound imaging, directly looking at the surface of the pelvis, and simultaneously according to the different imaging of the pelvic endometrium, pelvic wall and pelvic internal electrosurgical ring to guide the surgical treatment and improve the safety of the operation. During operation, the non-invasive grasping forceps should be used to pull the two sides of the tissue to be separated to maintain a certain tension. For thin avascular adhesions, cut directly with scissors. The thick vascular adhesion zone should be cut off after bipolar coagulation. Another method of blocking the release is to use a water rinse separation method. This requires a dedicated flush pump. It separates the loose glue directly. For more dense adhesion between different organs, it can form a peeling surface or create a potential cavity in the adhesion to facilitate the next sharp separation and reduce damage. For pelvic endoscopic surgery that causes severe pelvic obstruction, 150-200 ml of lactated Ringer's solution or sodium hyaluronate can be placed in the pelvic cavity to prevent postoperative adhesion. complication The difficulty of laparoscopic surgery lies in the decomposition of adhesions, and the formation of new adhesions after loosening the adhesion, which is the main factor for the failure of surgery.

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