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腹腔镜联合小切口全子宫切除术治疗超过1kg的巨大肌瘤子宫——个人经验

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中国微创外科杂志 2015年第1期15卷 1-5页

作者：黄胡信香港圣保罗医院妇产科香港999077

目的：介绍腹腔镜联合小切口全子宫切除术（ laparoscopy and minilaparotomy hysterectomy，LMH）治疗超过1 kg的巨大肌瘤子宫的手术技巧及结果。方法2011年5月～2013年12月，10例巨大肌瘤子宫（超过1 kg）患者接受LMH，其中6例联合附... 详细信息

目的：介绍腹腔镜联合小切口全子宫切除术（ laparoscopy and minilaparotomy hysterectomy，LMH）治疗超过1 kg的巨大肌瘤子宫的手术技巧及结果。方法2011年5月～2013年12月，10例巨大肌瘤子宫（超过1 kg）患者接受LMH，其中6例联合附件切除术。本文回顾性分析其病例特点、手术资料和结果。先使用腹腔镜探查评估卵巢、输卵管、粘连情况，以及子宫肌瘤的大小和位置。做＜6 cm的小切口。在腹腔镜照明和监视下，经小切口电凝卵巢或子宫血管。同样圆韧带、输卵管或卵巢骨盆漏斗韧带也可以使用传统的开放手术器械和技术电凝和分离。对巨大肌瘤子宫，在进行标准的子宫切除前通常需要先行肌瘤切除以缩小子宫体积，或先行子宫次全切除以将巨大肌瘤从宫颈分离。巨大子宫可以粉碎后经小切口取出。结果所有手术成功实施，无术中或术后并发症。平均手术时间2 h。所有患者术后恢复良好，出院时间1．5～3 d10结论对于超过1 kg的巨大肌瘤子宫，腹腔镜联合小切口全子宫切除术可以代替开腹全子宫切除术，是腹腔镜全子宫切除术外又一种安全、可行的微创手术。

关键词：腹腔镜小切口手术子宫切除术巨大肌瘤子宫

以盆腔大囊肿为表现的广泛型输卵管内膜异位囊肿:1例报告

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中国微创外科杂志 2015年第10期15卷 865-867页

作者：黄胡信香港圣保罗医院妇产科香港999077

本文报道一例罕见的广泛型输卵管内膜异位囊肿。患者为绝经后女性,主要表现为卵巢囊肿伴盆腔多个小囊肿样病变。有慢性盆腔疼痛病史,超声诊断为盆腔多囊性病变。由于并未意识到这种罕见的输卵管内膜异位大囊肿,在行腹腔镜探查时才予以... 详细信息

本文报道一例罕见的广泛型输卵管内膜异位囊肿。患者为绝经后女性,主要表现为卵巢囊肿伴盆腔多个小囊肿样病变。有慢性盆腔疼痛病史,超声诊断为盆腔多囊性病变。由于并未意识到这种罕见的输卵管内膜异位大囊肿,在行腹腔镜探查时才予以明确诊断。只有少数文献报道菜花状输卵管内膜异位囊肿表现为卵巢或盆腔肿物。本文不仅重点描述这一罕见表现,同时对相关问题进行探讨,包括术前诊断、腹腔镜下病灶外观、病理特点,并讨论应否在高风险患者中例行输卵管切除术,旨在减少高级别浆液性卵巢肿瘤的发生。

关键词：输卵管内膜异位症腹腔镜多囊病变苗勒系统

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腹腔镜网片骶骨阴道固定术治疗阴道穹隆脱垂

中华妇产科杂志 2012年第2期47卷 154-157页

作者：曾俐琴 Chou Danny wong felix 罗喜平广东省妇幼保健院妇科广州510010 澳大利亚新南威尔士大学圣乔治医院妇科腔镜中心澳大利亚新南威尔士大学利物浦医院妇产科

近几十年来,因各种疾病行子宫全切除术的病例增多,对术后阴道穹隆脱垂（vaginal vault prolapse,VVP）的治疗也日益受到重视.目前,仍无一种公认的方法能完美有效地治愈VVP,近年来临床医师对传统手术方法进行了不断的更新,认为经腹骶骨... 详细信息

近几十年来,因各种疾病行子宫全切除术的病例增多,对术后阴道穹隆脱垂（vaginal vault prolapse,VVP）的治疗也日益受到重视.目前,仍无一种公认的方法能完美有效地治愈VVP,近年来临床医师对传统手术方法进行了不断的更新,认为经腹骶骨阴道固定术（ abdominal sacrocolpopexy,ASC）是现今治疗VVP的标准术式[1-2].ASC是利用网片将脱垂的阴道高位悬吊固定于骶骨韧带,以恢复盆腔正常解剖和阴道轴向,维持阴道深度[3],治疗有效率为74％～98％[4-5],但其创伤大、恢复慢.近年来,有学者开展了腹腔镜骶骨阴道固定术（laparoscopic sacrocolpopexy,LSC）,效果与ASC相近,并且微创,无论是对性生活活跃的年轻妇女,或是老年女性,LSC均已成为治疗VVP的最佳术式[6-8].

关键词：骶骨阴道固定术阴道穹隆脱垂固定术治疗腹腔镜网片子宫全切除术标准术式治疗有效率

Surgical technique of video endoscopic inguinal lymphadenectomy via a hypogastric subcutaneous approach

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Chinese Medical Journal 2013年第16期126卷 3181-3183页

作者： WANG Yi-feng CHEN Gao-wen WENG Hui-nan SHENG Xiu-jie felix wong Department of Obstetrics and Gynecology Zhujiang HospitalSouthern Medical University Guangzhou Guangdong 510282 China Department of Obstetrics and Gynecology Third Affiliated Hospitalof Guangzhou Medical College Guangzhou Guangdong 510150China Minimally Invasive Gynecology Unit St. Paul's Hospital HongKong China

Open inguinal lymphadenectomy is a necessary conventional management for the lower genitourinary malignancies,but the associated morbidity remains an issue for the conventional surgical *** endoscopic inguinal lymphadenectomy via the limb subcutaneous approach （VEIL-L） has recently been reported as a potentially less invasive alternative to the open inguinal lymphadenectomy for patients with some genitourinary malignancies.1-4 The concept of VEIL-L was first described by the French gynecologists.1-2 Since then,this procedure has undergone a few technical *** triangular working space can be obtained by introducing the laparoscopic instruments through three1,2,4 or a single working port3 in the ***,laparoscopic pelvic lymphadenectomy （LPL） had to be performed with three or more abdominal working ports if the frozen section revealed positive deep inguinal *** avoid the need to operate both through the limb and the abdomen in this situation,a new approach described in this paper should resolve the issue of the number of access routes with the possible better reduction of infection and morbidity from wound breakdown.

关键词： endoscopy inguinal lymphadenectomy pelvic lymphadenectomy vulvar cancer

Value of the pudendal nerves terminal motor latency measurements in the diagnosis of occult stress urinary incontinence

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Chinese Medical Journal 2011年第23期124卷 4046-4049页

作者： ZHU Lan HAI Ning LANG Jing-he YU Shi-yun LI Bin wong felix Department of Obsterics and Gynecology Peking Union Medical College Hospital Peking Union Medical College Beijing 100730 China

Background Occult stress urinary incontinence may lead to de novo stress urinary incontinence after pelvic floor repair surgery. A measurement of pudendal nerve terminal motor latency can reflect the integrity of the nerves. We aimed to explore the value of pudendal nerve terminal motor latency in the diagnosis of occult stress urinary incontinence in pelvic organ prolapse patients. Methods Ten patients with stress urinary incontinence （SUI group）, 10 with SUI and uterine or vaginal prolapse （POP＋SUI group） and 10 with uncomplicated uterine or vaginal prolapse （POP group） were evaluated for their pudendal nerve terminal motor latency using a keypoint electromyogram. Results The amplitude of positive waves was between 0.1 and 0.2 mV. The nerve terminal motor latency was between 1.44 and 2.38 ms. There was no significant difference in the wave amplitudes of pudendal nerve evoked action potential among the three different groups （P 〉0.05）. The pudendal nerve latency of the SUI group, POP＋SUI group and POP group were （2.9_＋0.7） seconds, （2.8_＋0.7） seconds and （1.9_＋0.5） seconds respectively. The difference between the SUI group and POP＋SUI group was not statistically significant （P 〉0.05）, whereas the difference between the SUI and POP groups and between the POP＋SUI and POP groups were statistically significant （P 〈0.05）. There was a positive correlation between pudendal nerve latency and the severity of SUI; the correlation coefficient was 0.720 （P 〈0.01）. Conclusions Patients with SUI may have some nerve demyelination injuries in the pudendal nerve but the damage might not involve the nerve axons. The measurement of pudendal nerve latency may be useful for the diagnosis of SUI in POP patients.

关键词： pelvic organ prolapse stress urinary incontinence occult pudendal nerves terminal motor latency

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“隐蔽瘢痕”的改良三孔技术

中国微创外科杂志 2014年第1期14卷 1-3页

作者：黄胡信澳大利亚悉尼新南威尔士大学医学院妇女和儿童健康学院妇产科中国-澳大利亚-亚洲太平洋地区微创妇科专家论坛委员会(FEC) 中国-亚洲太平洋地区微创妇科肿瘤协会

腹腔镜手术已成为妇科手术的选择之一。然而经典的腹腔镜手术仍会留下3～4个切口瘢痕。瘢痕是手术的标志，因此，没有手术是没有“瘢痕”的。即使是代表内镜技术最新改进和进展的单孔腹腔镜手术（single incision laparoscopic surgery... 详细信息

腹腔镜手术已成为妇科手术的选择之一。然而经典的腹腔镜手术仍会留下3～4个切口瘢痕。瘢痕是手术的标志，因此，没有手术是没有“瘢痕”的。即使是代表内镜技术最新改进和进展的单孔腹腔镜手术（single incision laparoscopic surgery，SILS）仍然会产生瘢痕。虽然只有单一切口，瘢痕数量减少，且不明显，但对医生和病人而言并非如此。

关键词：切口瘢痕三孔技术 laparoscopic 腹腔镜手术 surgery 改良妇科手术内镜技术

Incidence of deep venous thrombosis after gynaecological laparoscopy

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Chinese Medical Journal 2001年第6期114卷 72-75,108-109页

作者：冯力民夏恩兰首都医科大学附属北京天坛医院妇产科北京100050

Objective　To evaluate the incidence of deep venous thrombosis (DVT) after gynaecological ***　The incidence of DVT was studied in 72 consecutive patients who underwent gynaecological laparoscopy in the Liverpool Health Service between May and September 1997. B-mode ultrasound supplemented by Doppler was used to examine venous patency and intraluminal echoes to diagnose DVT. Sixty-one patients who had pneumoperitoneum less than 60 minutes were classified a minor procedure and 11 who had pneumoperitoneum more than 60 minutes were classified as major procedure. Two Doppler ultrasound scans were planned for every patient. The first one was done within 24 hours and the second was performed on day 7 post-surgery. All 72 patients had the first scan and 40 out of 61 in the minor procedure group and 9 out of 11 in the major procedure had the second scan. Twenty-three patients who did not come for the second scan were followed up by ***　No DVT was found in our ***　This study confirms an impression that gynaecological laparoscopic procedure has a very low incidence of DVT. If it occurs, the diagnosis and treatment must be made as soon as possible so that the fatal complications such as pulmonary embolus can be avoided.

关键词： laparoscopic surgery · deep venous thrombosis

Recent advances in minimally invasive pelvic floor surgery

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Recent advances in minimally invasive pelvic floor surgery

“2007年澳大利亚-中国-亚太地区妇科内镜论坛”在悉尼获圆满成功

中华医学会第一届全球华人妇产科学术大会暨第三次全国妇产科中青年医师学术会议

作者： felix wong,University of New South Wales,Sydney,Australia Huxin Huang

Many traditional surgeries for genital prolapse have a high failure rate and recurrence is *** the ad- vance of various vaginal mesh surgery and laparoscopic surgery,genital prolapse surgery has entered into a new phase of *** early laparoscopic application of non-absorbable sutures to strengthen and shorten the round liga- ments,and uterosacral ligaments had met with failures despite the early claim of *** might be due to the uncer-

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中国微创外科杂志 2007年第12期7卷 1233-1236页

作者：傅贤波 felix wong

为促进微创妇科的国际学术交流,学习微创妇科的国际经验,在澳大利亚著名微创妇科专家felix wong教授的倡导和精心安排下,由澳大利亚悉尼新南威尔士大学、亚洲太平洋地区妇科内镜协会(APAGE)、《中国微创外科杂志》编辑部联合举办的2007... 详细信息

为促进微创妇科的国际学术交流,学习微创妇科的国际经验,在澳大利亚著名微创妇科专家felix wong教授的倡导和精心安排下,由澳大利亚悉尼新南威尔士大学、亚洲太平洋地区妇科内镜协会(APAGE)、《中国微创外科杂志》编辑部联合举办的2007年第二届澳大利亚-中国-亚太地区妇科内镜论坛于2007年9月15～17日在澳大利亚悉尼利物浦医院胜利召开.

关键词：妇科内镜手术演示悉尼中华人民共和国澳大利亚大洋洲