1. Abdominal skin preparation is the same as general abdominal surgery, but special attention should be paid to the cleaning of navel, because it is necessary to puncture the navel.
2. The intestinal tract should be given a semi-liquid diet one day before operation, and fasting should be performed from the night before operation 10 to before operation. Clean enema the night before operation and the morning of operation.
3. Vaginal preparation includes the operation of uterine cavity and vagina and the placement of uterine lifting rod. Before operation, vaginal discharge should be checked and vaginal cleaning should be carried out. Patients with vaginal inflammation should be cured before operation.
4. Blood routine examination should be done before blood matching.
5. Take sedatives orally one night before operation to ensure the quality of sleep and facilitate cooperation with the operation. The medication before anesthesia is determined according to the anesthesia method.
6. Catheter must be placed before indwelling catheter to empty bladder.
7. According to the patient's condition, combined with the size and difficulty of the operation, general anesthesia, epidural anesthesia, spinal anesthesia and local anesthesia are selected as appropriate.
8. Hysteroscopy generally works best in 3-7 days after menstruation is clean.
9. Sexual life is forbidden after menstruation or 3 days before surgery.
10, urine can be properly filled before operation, which is convenient for intraoperative B-ultrasound monitoring.
1 1, preoperative examination: examination of infectious diseases (hepatitis B surface antigen, HIV, HCV, RPR), small liver function, renal function, electrocardiogram, routine hematuria, routine coagulation and routine leucorrhea.
12, 1 Take the pathological results to see a doctor after operation.
13, a small amount of vaginal bleeding can occur within 2 months after hysteroscopic electrotomy, and the third month is normal menstruation. Hysteroscopy is a new minimally invasive gynecological diagnosis and treatment technology, which can be used for the diagnosis, treatment and follow-up of intrauterine diseases. It can avoid laparotomy, keep the uterus, and only destroy and destroy the lesion. And what should I pay attention to after hysteroscopic surgery? Due to improper nursing, it is easy to cause sequelae of laparoscopic surgery. Although laparoscopic surgery recovers quickly and has little surgical trauma, we must pay attention to the following points:
1. Within 6 hours after operation, take the supine position with the head on the side to prevent vomit from being inhaled into the trachea;
2. Because most patients have no pain after operation, don't neglect to massage the patient's waist and legs, and turn over for the patient every half hour to promote blood circulation and prevent bedsores;
3. The catheter can be removed when the fluid is lost that day, and the patient is encouraged to get out of bed.
4. Patients can be fed a small amount of liquid diet 6 hours after operation, such as thin rice soup and noodle soup. Do not give patients sweet milk, soy milk powder and other sugary drinks;
5. The incision of laparoscopic surgery is only 1 cm, so after one week, you can remove the abdominal bandage and take a bath, and then you can gradually return to normal activities. A week ago, you should pay attention to proper light activities to make your body recover as soon as possible. Difference from traditional open surgery
1, abdominal cavity is not cut, and it is not exposed to air.
2. With the help of the camera system, the exposure of the operation field is more adequate than that of the traditional operation.
3. The upper part of the operation will not be disturbed by unnecessary operation.
4. Incision, ligation and hemostasis mainly rely on electrocoagulation surgery, and foreign bodies in the surgical site are significantly reduced, and pelvic adhesion is reduced. The traditional open hysteroscopy minimally invasive surgery incision needs an incision about 10 cm long. No incision hysteroscopy only needs three small incisions of 3 mm More bleeding and less postoperative pain. The pain is obvious, but not obvious. The infection rate is higher, the tissues are easier to adhere, and the infection rate is lower. Tissue is not easy to adhere. Get out of bed for 24 hours in hospital, get out of bed for 3 hours in 7 days and get out of bed for 3 months. The scar length is obviously 1-2 months. No scars or only slight scars.
Laparoscopic minimally invasive surgery has been successfully applied to surgery through the efforts of leading doctors in many countries. Let's look back at history and understand its development.
190 1 year, Ott, a gynecologist in Petersburg, Russia, made a small incision in the anterior abdominal wall, inserted the speculum into the abdominal cavity, and reflected the light into the abdominal cavity with the head mirror to examine the abdominal cavity, which is called laparoscopy.
19 10 Jacobs of Stockholm, Sweden first used the term laparoscopy, and he made pneumoperitoneum with trocar.
19 1 1 year, Bernhein, a surgeon at Johns Hopkins Hospital in the United States, inserted a proctoscope into the abdominal cavity through an abdominal incision, and used the emitted light as the light source.
1924 Si Stone, a physician in Kansas, USA, inserted a nasopharyngoscope into the abdominal cavity of a dog, and recommended using a rubber gasket to help seal the puncture cannula to avoid air leakage during the operation.
1938, Hungarian surgeon Veress introduced an air injection needle, which can be safely made into pneumothorax. When doing pneumoperitoneum, it can prevent the needle tip from damaging the viscera under the needle. The idea of making pneumoperitoneum with unsafe puncture needle is widely accepted and is still in use today.
Calker, a German gastroenterologist, invented a straight forward strabismus lens system of135. He is regarded as the founder of laparoscopic diagnosis of hepatobiliary diseases in Germany. He first advocated the use of double cannula puncture needle technology in 1929.
1972 The American Association of Gynecological Laparoscopic Physicians plans to complete nearly 500,000 abdominal examinations in the next few years, which has been widely accepted by gynecologists. Nearly13 of gynecological operations in Cedars-Sniai Medical Center in Los Angeles are diagnosed or treated by laparoscopy.
Cuschieri started the animal experiment of laparoscopic cholecystectomy in 1986. At 1988, the first world congress of surgical endoscopy, he reported a successful case of laparoscopic cholecystectomy in experimental animals, which was applied to clinic in February 1989.
Philipe Mouret, a French surgeon who successfully performed laparoscopic cholecystectomy for the first time, successfully performed laparoscopic cholecystectomy for the same patient while treating gynecological diseases in 1987, but it has not been reported.
1May, 988, Dubois in Paris carried out the experiment of laparoscopic cholecystectomy in pigs and applied it to clinic. The results were first published in France, and the video of the operation, 1989, was shown at the annual meeting of the American Gastroenterologists Association in April, which caused a sensation all over the world. It first shook the surgical field in the United States, and the upsurge of laparoscopic cholecystectomy rose in the United States, which made laparoscopic cholecystectomy develop from animal experiment and clinical exploration to clinical development.
199 1 February, Xun Zuwu completed the first laparoscopic cholecystectomy in China, which was also the first laparoscopic operation in China. In the past 20 years, more than 40 kinds of laparoscopic surgery have been carried out in China, with more than 1 10,000 cases.
At present, laparoscopic minimally invasive surgery is widely used and has been well received by the majority of patients.