Transvaginal puncture for ovarian endometrioma cyst

Interventional operation is the use of ultrasound, computed tomography (CT), nuclear magnetic resonance (MRI), X-ray, laparoscopy and other modern medical imaging technology to perform targeted surgery on the organs and tissues of the lesion for diagnosis and treatment. purpose. The law has now become an indispensable part of comprehensive treatment. Due to its advantages of micro-trauma, accurate positioning, safety and effectiveness, and fewer complications, it has developed rapidly in the past 20 years. Generally divided into two major categories of vascular interventional surgery and non-vascular interventional surgery. On the basis of vascular interventional surgery, the surgical methods are gradually developed and perfected, and various operations are mainly performed under the guidance of ultrasound, laparoscopy, hysteroscopy, and fetal mirror. Such as puncture, biopsy, aspiration, intubation, injection of drugs, local hyperthermia and other surgical methods. The method has the advantages of clear image, high sensitivity, no X-ray damage, simple operation, low cost and repeated operation. Treating diseases: endometriosis Indication Transvaginal puncture for ovarian endometriotic cysts is suitable for: 1. B-diagnosis is clearly defined as endometriotic cysts, diameter greater than 3cm, the cysts are clear, consistent with the imaging findings of the disease. 2. CT and pelvic gynecological examination is basically determined as endometriosis. 3. The possibility of clinical exclusion of malignant tumors. 4. A history of typical endometriosis or surgery has been confirmed as the disease, relapse without treatment or treatment. 5. Choose a lower position in the pelvis, a single room or only 1 to 2 rooms with a high success rate. Contraindications 1. Highly suspected pelvic mass is a malignant tumor. 2. When the puncture under the guidance of B-ultrasound is found to be not chocolate liquid and suspicious malignant or other tumor, stop the operation immediately. The extract was sent for pathological examination. 3. Severe pelvic adhesions, have been laparoscopic surgery history or repeated cyst puncture disabled. 4. For those with a history of pelvic inflammatory disease, choose carefully and use antibiotics before surgery. Surgical procedure 1. Menstruation clean 3 ~ 5d, vulva, vaginal routine disinfection, disinfection towel, to maintain sterility. 2. Transvaginal B-ultrasound pelvic scan to determine the nature, size, location of the cyst and its correlation with surrounding organs and tissues. 3. According to the B-ultrasound image, determine the puncture site and direction. 4. Using Japanese ALOKA, SSD-630 ultrasonic instrument, with 5MHz vaginal probe and PTC needle, through the guide, cyst puncture, extract the capsule fluid. 5. If the fluid in the capsule is thick and the suction resistance is large, it can be injected with physiological saline, repeatedly diluted and then aspirated until the color of the extract becomes reddish or clear. 6. Calculate the total amount of the extract, according to the amount of 1/6 to 1/8 (large cysts as appropriate), inject ethanol into the capsule, keep it for 10 minutes, and then clean the fixative. 7. During the operation, observe the patient's complaint and withdraw the amount of cyst fluid. If there is sudden abdominal pain or alcohol allergy symptoms, stop the operation immediately and repeatedly use saline to aspirate the cyst. complication 1. Intraoperative and postoperative injection of ethanol caused by facial flushing, increased heart rate, nausea, vomiting, and immediately stop surgery. Wash cysts in time, anti-allergic drugs, oxygen, infusion treatment. 2. Inadequate operation due to inadvertent operation, unclear image or severe cyst adhesion, can occur through the intestinal tube, when the fluid traits such as intestinal fluid, immediately stop surgery, hospital observation, the use of antibiotics. 3. When the ethanol overflows due to surgery, it should be immediately pumped. Under the guidance of B-ultrasound, look for the spilled part, stop the operation, observe the development of the disease and use antibiotics.