妇科微创手术理念及经阴道手术未来

Concept of minimally invasive gynecological surgery and future of transvaginal surgery

摘要:

微创外科的发展经历了近百年的历史，涉及临床所有专业，在手术治疗中尤为突出。妇科微创技术主要通过经阴道手术、内镜技术及介入治疗实现。内镜技术从最初的宫腔镜、腹腔镜检查，发展到如今在宫腔镜、腹腔镜下几乎可以完成各种妇科疾病的治疗。放射及超声等介入治疗也是微创手术不可或缺的措施。然而各种术式均有其利弊，随着微创理念的深入，经阴道手术的价值越来越被临床医师及患者肯定。经阴道手术在全子宫切除术、子宫肌瘤剔除、盆底重建方面优势明显。经阴道手术的适应证也随着手术技能的提高而不断扩展，势必会在未来手术中得到更广泛的应用。临床医师应该掌握各种手术方式，又要彰显自己的特长，针对具体疾病选择最适宜的手术方案，在保证手术效果及安全性的前提下，尽量选择微创手术，使患者受益。

Abstract:

The development of minimally invasive surgery has a history of nearly 100 years, involving all clinical specialties, especially in surgical treatment. In the field of gynecology, minimally invasive surgery is mainly achieved through vaginal, endoscopic and interventional treatment. Endoscopic surgery has developed from the initial hysteroscopy to almost complete the treatment of various gynecological diseases under hysteroscopy, such as gynecological emergency, gynecological benign and malignant tumors, pelvic floor reconstruction, and hysteroscopy for uterine diseases. Interventional therapy such as radiation and ultrasound is also an indispensable measure for minimally invasive surgery. However, each type of operation has its advantages, disadvantages and limitations. With the deepening of the minimally invasive concept, the value of transvaginal surgery is increasingly recognized by clinicians and patients. The advantages of transvaginal surgery are obvious in total hysterectomy, myomectomy, and pelvic floor reconstruction. The indications of transvaginal surgery are also expanding with the improvement of surgical skills, which is bound to be more widely used in future surgical treatment. Doctors should master various surgical methods, be good at forming their own expertise, select the most appropriate surgical plan for specific diseases, and try to choose minimally invasive surgery to benefit patients on the premise of ensuring the surgical effect and safety.