Triangular subtotal hysterectomy

In recent years, some scholars believe that for the benign uterine lesions, in order to minimize the destruction of the pelvic anatomy, save a good blood supply, support the patient physiologically and psychologically, and propose a "triangular hysterectomy" procedure. Treatment of diseases: uterine sarcoma uterine cancer Indication This procedure is suitable for young patients with uterine fibroids. Contraindications Pelvic malignant lesions (except early onset carcinoma in situ), endometriosis and pelvic inflammatory disease with extensive pelvic adhesions, larger and lower cervical fibroids, broad ligament fibroids, with larger and cohesive Attachment mass (>6cm diameter), the height of the fundus is higher than the umbilicus, and the vagina is extremely narrow. Preoperative preparation Cervical smear and diagnostic curettage were performed before surgery to exclude cervical and uterine malignant tumors. Surgical procedure This procedure uses an inverted triangle wedge to remove the uterus, retains part of the uterine body, does not cut the uterine artery, and forms a "small uterus" after surgery, which can significantly reduce postoperative complications. complication 1. Bleeding: When dealing with uterine round ligament, ovarian intrinsic ligament, and fallopian tube, the end of the suture is not tight or the knot is slippery and causes bleeding, so double ligation is appropriate. When cutting the uterine arteries and veins, the tissue surrounding the uterine arteries and veins should be separated as much as possible, the blood vessels should be recognized, and the uterus should be clamped tightly and firmly ligated. When pushing down the bladder, it is necessary to distinguish the levels, too shallow or too deep will cause bleeding. 2. Adjacent organ injury: Because subtotal hysterectomy is often used for adhesion between uterus and pelvic organs, especially when the bladder, rectum and cervical adhesions are dense, the anatomical level is not clear, and bladder, rectum and ureteral damage are prone to occur. Once it appears, it should be patched immediately.