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題名 | Laparoscopic Extraperitoneal Sacrospinous Suspension for Vaginal Vault Prolapse=利用腹膜外腹腔鏡骶骨坐骨脊韌帶懸吊術治療陰道穹窿脫垂的病人 |
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作者 | 李奇龍; 王錦榮; 顏志峰; 宋永魁; Lee, Chyi-long; Wang, Chin-jung; Yen, Chih-feng; Soong, Yung-kuei; |
期刊 | 長庚醫學 |
出版日期 | 20000200 |
卷期 | 23:2 2000.02[民89.02] |
頁次 | 頁87-91 |
分類號 | 417.3 |
語文 | eng |
關鍵詞 | 腹腔鏡; 腹膜外; 骶骨坐骨脊韌帶懸吊術; 陰道穹癃脫垂; Laparoscopy; Extraperitoneal; Sacrospinous suspension; Vaginal vault prolapse; |
英文摘要 | Background. A new laparoscopic sacrospinous suspension procedure is described for the correction of vaginal vault prolapse using an extraperitoneal approach. This is the first report in the literature of the extraperitoneal approach. Methods. We reviewed 12 women who had been treated in our hospital using this technique because of vaginal vault prolapse. These women had undergone hysterectomies (10 abdominal; 2 vaginal) between 5 and 22 years previously (mean, 12 years). After pre-laparoscopic preparation, a 10-mm trocar with a 10-mm zero- degree telescope was placed into the Retzius space. Using a direct air-distended method with a 20 mmHg insufflation pressure, Retzius and para-rectal spaces were created. The sacrospinous ligament could be easily identified and confirmed. A permanent suture was then inserted from the sacrospinous ligament to the vaginal vault to ensure that there was no space in between. Results. This procedure was followed for all 12 patients. There were no major complications during surgery. Eleven women had no recurrence of vaginal vault prolapse during a follow-up period of 1 to 3 years (mean, 2.2 years). One patient developed recurrent vaginal vault prolapse; however, she subsequently underwent a successful colposacropexy by laparoscopy 23 months after the initial surgery. Conclusion. We modified the traditional sacrospinous fixation laparoscopically, following principles to restore the correct anatomic position of the vault. Laparoscopic extraperitoneal sacrospinous suspension can eliminate the procedure of opening and closing the peritoneum and avoid interference with the intestine during surgery. It can be used as an alternative to traditional genital suspension surgeries. |
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