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Modern surgical approaches to female reproductive tract.
Human Reproduction Update ( IF 13.3 ) Pub Date : 1996-09-01 , DOI: 10.1093/humupd/2.5.419
T Tulandi 1
Affiliation  

Laparoscopic and hysteroscopic surgery have changed the management of many gynaecological disorders. Procedures that previously required a long duration of hospitalization can now be done on an outpatient basis or with a short hospital stay. Surgical treatment remains the definitive and universal treatment of ectopic pregnancy and it can be safely done by laparoscopy. Most reproductive operations are done by laparoscopy and the results appear to be similar to those obtained with laparotomy. Those needing a laparotomy will be better treated by in-vitro fertilization. Laparoscopic ovarian drilling is a viable alternative for infertile women with polycystic ovarian syndrome. Most ovarian cysts and endometriosis should be treated by laparoscopy. Although uterine myomas can be removed by laparoscopy, the uterine integrity after the procedure is questionable. Surgery should be reserved for women who have completed their family or those with pedunculated or shallow intramural myomas. Alternatively, a laparoscopically assisted myomectomy can be done. For laparoscopic hysterectomies for benign lesions, supracervical hysterectomy appears to be a good option. Hysteroscopy has changed our management, particularly for abnormal uterine bleeding. A submucous myoma and polyp can be removed by hysteroscopy and, as an alternative to hysterectomy, endometrial ablation can be done. In the future, most procedures will be done by endoscopy and laparotomy will be reserved only for selected cases.

中文翻译:

女性生殖道的现代手术方法。

腹腔镜和宫腔镜手术改变了许多妇科疾病的治疗方法。以前需要长期住院的手术现在可以在门诊或住院时间短的情况下进行。手术治疗仍然是异位妊娠的权威性和普遍性治疗,可以通过腹腔镜检查安全地进行。大多数生殖手术都是通过腹腔镜进行的,结果似乎与剖腹手术相似。需要剖腹手术的患者可以通过体外受精得到更好的治疗。对于多囊卵巢综合征的不育妇女,腹腔镜卵巢钻孔是一种可行的选择。大多数卵巢囊肿和子宫内膜异位症应通过腹腔镜检查治疗。尽管可以通过腹腔镜切除子宫肌瘤,手术后的子宫完整性值得怀疑。应该为已经完成家庭或患有带蒂或浅壁壁肌瘤的妇女保留手术。或者,可以进行腹腔镜辅助的子宫肌瘤切除术。对于用于良性病变的腹腔镜子宫切除术,上腹子宫切除术似乎是一个不错的选择。宫腔镜改变了我们的治疗方法,尤其是对于异常子宫出血。可通过宫腔镜切除粘膜下肌瘤和息肉,作为子宫切除术的替代方法,可进行子宫内膜切除术。将来,大多数手术将通过内窥镜检查完成,而剖腹手术仅保留给特定病例。可以进行腹腔镜辅助的子宫肌瘤切除术。对于用于良性病变的腹腔镜子宫切除术,上腹子宫切除术似乎是一个不错的选择。宫腔镜改变了我们的治疗方法,尤其是对于异常子宫出血。可通过宫腔镜切除粘膜下肌瘤和息肉,作为子宫切除术的替代方法,可进行子宫内膜切除术。将来,大多数手术将通过内窥镜检查完成,而剖腹手术仅保留给特定病例。可以进行腹腔镜辅助的子宫肌瘤切除术。对于用于良性病变的腹腔镜子宫切除术,上腹子宫切除术似乎是一个不错的选择。宫腔镜改变了我们的治疗方法,尤其是对于异常子宫出血。可通过宫腔镜切除粘膜下肌瘤和息肉,作为子宫切除术的替代方法,可进行子宫内膜切除术。将来,大多数手术将通过内窥镜检查完成,而剖腹手术仅保留给特定病例。
更新日期:2019-11-01
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