Laparoscopic surgery is one of the ways to realize the concept of minimally invasive surgery. An inevitable trend in the development of surgery. Using a working channel, the "Trocar" incision, instead of an open abdominal incision, the results are equal to or better than open surgery.
It mainly includes:
1. Diagnosis and treatment of infertility
Unexplained infertility is the primary indication for laparoscopy. Under laparoscopy, the patencies of fallopian tubes and the relationship with surrounding tissues were determined. Complementary to HSG. Intraperitoneal environmental factors: minor changes in the intraperitoneal environment caused by endometriosis are the cause of infertility. A disorder of conception caused by adhesion between the pelvis and abdominal cavity.
Uterine morphology, ovarian morphology, excluding the infertility caused by partial uterine malformation. Treatment such as PCOS---- ovarian perforation.
2. Diagnosis and differential diagnosis of gynecological acute and chronic abdominal pain
Application of laparoscopy in the diagnosis of acute abdomen:Diagnosis and treatment of hemorrhagic diseases of pelvic and abdominal cavity: ectopic pregnancy, rupture of pelvic and abdominal organs (ruptured corpus luteum of ovary, uterine perforation, intestinal perforation). Diagnosis and treatment of pelvic and abdominal inflammatory diseases: pelvic peritonitis, pelvic abscess. Complications related to pelvic abdominal mass: torsion and rupture of the pedicle of ovarian mass; Subserous uterine fibroid torsion, fibroid degeneration. Other acute abdominal pain: intussusception, volvulus, intestinal necrosis. The value of laparoscope in the diagnosis of new gynecological acute abdomen: laparoscope treatment of cesarean section scar pregnancy; Laparoscopic repair of cicatricial diverticulum from cesarean section
3.Location, origin, nature, size and biopsy of the pelvic abdominal mass
Application of laparoscopy in chronic pelvic pain:Non-invasive examination of chronic pelvic dyspenorrhea can not determine the cause → laparoscopic exploration, pelvic abdominal adhesion, endometriosis and so on. Diagnose chronic pelvic pain caused by non-reproductive factors, such as chronic appendicitis. Pain localization for primary dysmenorrhea and secondary dysmenorrhea.
Diagnosis and differential diagnosis of pelvic masses:Diagnosis of postmenopausal adnexal mass, < 3cm. The nature judgment of pelvic mass, benign and malignant; Neoplastic, tumorigenic; Source of mass: ovary, uterus, retroperitoneum.
Diagnosis of pelvic mass and ascites by laparoscopy:Large effusion in pelvic cavity without pelvic mass: ovarian cancer? Peritoneal carcinoma? Tuberculosis of pelvic cavity? Diagnosis of pelvic masses: tuberculosis? Malignant tumor? In different disease? Inflammatory mass? Tumor biopsy → condoned tumor rupture, causing the risk of tumor spread. Peritoneal biopsy: confirm the diagnosis.