Recently, the gynecology team of Shenzhen Dapeng New District Maternal and Child Health Hospital successfully performed single-port laparoscopic surgery on an emergency patient who was 24 weeks pregnant and had ovarian cyst torsion . The operation not only saved the patient's life, but also preserved the patient's fetus. , the operation was jointly performed by Fang Guangguang, deputy director of the hospital, and Tan Yan, director of gynecology, and was the first in Shenzhen. "Fortunately, the operation was timely and we were able to save the fetus and continue the pregnancy."
It is reported that the patient, Ms. Du, is 25 years old and 24 years pregnant. Zhou, due to unbearable lower abdominal pain for 3 hours, she was accompanied by her family to the Dapeng New District Maternal and Child Health Hospital for examination. The patient reported that the pain in the right lower abdomen was the most obvious, accompanied by nausea and vomiting twice. The B-ultrasound of the hospital showed that she was in the second trimester of pregnancy. , single live fetus, 24 weeks of pregnancy, the size of the cyst in the right accessory area of the mother's body was about 65×45mm, so the outpatient department was admitted to the gynecology department for "ovarian cyst pedicle torsion". After combined with the B-ultrasound diagnosis, Tan Yan, director of the gynecology department of the hospital, initially considered that Ms. Du was pregnant and had ovarian cyst torsion. However, considering that the patient was 24 weeks pregnant, the condition was complicated, and the operation was difficult. Director Tan Yan immediately after the physical examination Notified Fang Guangguang, the vice president of business affairs of the hospital, and immediately called medical staff from the Department of Medical Education, Department of Anesthesiology, Department of Surgery and Pediatrics to start a multidisciplinary seminar. Due to the special situation of the patient, who is a pregnant woman in the second trimester, a single-port intraperitoneal surgery was considered based on the condition. Microscopic surgery can best protect the health of mother and baby. After discussing and agreeing with the patient and her family, the hospital immediately opened a green channel for Ms. Du. Multi-disciplinary cooperation was carried out in an orderly manner. All preoperative preparations and vital sign monitoring were completed in just 6 minutes, and the hospital performed a single-hole emergency surgery on Ms. Du. Laparoscopic right adnexectomy . Fang Guangguang told reporters, "Generally, single-port laparoscopic surgery is recommended to be performed around 13 weeks of pregnancy. Considering that the uterus is enlarged at this time, the intraoperative operation may damage the uterus, and the pneumoperitoneum pressure may also stimulate uterine contraction. The fetus is now very mature. It leads to late threatened abortion or miscarriage, so it is very difficult and requires high cooperation from multiple departments such as gynecology, anesthesiology, pediatrics, and surgery. In order to avoid uterine stimulation as much as possible, the anesthesia method of tracheal intubation is used. "
Fang Guangguang and Tan Yan led the team. The gynecology team works closely with the Department of Anesthesiology, Pediatrics, and Surgery to ensure the health of the mother and baby. Drugs that inhibit uterine contractions are used to reduce stimulation of the uterus. The fetus is closely observed during the operation, and an arc-shaped incision about 4cm long is made on the upper edge of the umbilicus. , to a single puncture device, double-click electrocoagulation to twist the pedicle of the right ovarian cyst, then use the ultrasonic scalpel to separate the pedicle and remove the right appendage. During the entire process, the fetal heart rate in the patient's abdomen remained normal, no uterine contractions occurred, and the operation was only It took 20 minutes, but Ms. Du was finally able to save the fetus, save the ovaries, and continue the pregnancy. It is reported that after the operation, the hospital provided careful care and strict monitoring of the patient's condition and fetal heart rate. The patient is currently recovering well, with no uterine contractions or other discomforts, and the small postoperative incision is slowly healing.
According to reports, because laparoscopic minimally invasive surgery has less trauma, faster recovery, and less pain, on this basis, single-port laparoscopic surgery, which has just been developed in recent years, has become more popular in the New District Women's Health Hospital because of its smaller trauma, more beautiful appearance, and good recovery. Single-port laparoscopy has been widely used in the treatment of gynecological and surgical diseases, and this single-port laparoscopic ovarian cyst pedicle torsion surgery is the first in the new area. "This kind of difficult and complex third and fourth types of surgeries that could not be carried out in the new area in the past can now be carried out on a daily basis with the establishment of Dapeng New Area Medical Health Group, high-quality medical resources are sinking, and experts from the Municipal Second Hospital are stationed to provide guidance." Wu Daoshen, director of Dapeng New District Maternity and Child Health Hospital, told reporters, "To allow residents in the new district to see famous doctors at their doorsteps and treat serious diseases, we now have a local medical team with excellent quality."
Knowledge expansion:
Ovarian cyst pedicle torsion It means that the blood vessels supplying the ovarian cysts are twisted, causing the ovarian cysts to be ischemic, even necrotic and ruptured, causing severe abdominal pain. It is one of the gynecological acute abdomen . About 10% of ovarian cysts have pedicle torsion, which often occurs when the tumor pedicle is long, Tumors that are moderately large, well mobile, and centered on one side (such as teratomas). Pedicle torsion often occurs when the patient suddenly changes body position, or when the size or position of the uterus changes during pregnancy or puerperium. Once pedicle torsion is diagnosed, surgical treatment should be performed as soon as possible.
Tan Yan reminded the general public: "Generally speaking, ovarian cysts not exceeding 5cm do not require surgery. Ordinary physical therapy and drug treatment are enough. However, if pedicle torsion occurs, even if the cyst does not exceed 5cm, surgery must be performed. Ovarian cysts or tumors have a pedicle, which includes the fallopian tube, the pelvic infundibular ligament and the proper ovarian ligament. When the pedicle rotates in one direction, it is called an ovarian cyst or ovarian tumor torsion. Once the ovarian cyst pedicle torsion occurs, it supplies the ovarian cyst. The blood vessels will become twisted, causing ovarian cysts to become ischemic, even necrotic and ruptured, causing severe abdominal pain, so it must be paid enough attention to, and annual routine physical examination is necessary to detect the disease in time and treat it in time to avoid adverse consequences. "
