腹腔镜下腹膜阴道成形术术式改良与探讨(附6例报告)

目的探讨该院常规腹腔镜下腹膜阴道成形术改良方法。方法经人工穴道钳夹翼状腹膜皱襞上缘。牵拉至穴道外口，形成阴道壁，镜下利用膀胱顶、直肠前及两侧盆壁腹膜作镜下荷包缝合，形成阴道顶；改良术式改为钝性剥离盆底腹膜及盆侧壁腹膜，钳夹盆底腹膜最低点，而不是翼状腹膜皱襞上缘。结果手术：原术式60-100min，平均70min；改良术式35～50min，平均40min。结论牵拉腹膜容易，术后阴道壁腹膜易成活，对膀胱无干扰。手术简便易行。

Study of operating method of vaginoplasty under laparoscopic surgery

Objective]To approach the improving routine method of the vaginoplasty under the laparoscopic surgery so as to make easier. The wing-shaped folds of the peritoneum, taken form the wall of vagina, could be pulled to the outer hole by the artificial passageway. The peak of the bladder, the front of rectum and two sides of the peritoneum were sewed and consisted of the peak of the vagina. The peritoneum was separated and the lowest point of the peritoneum was pulled instead of the wing-shaped folds of the peritoneum in the improved method. The operation time by the routine method was 60~100 minutes (mean: 70 minutes), that by the improving method was 35~50 minutes (mean: 40 minutes). Conclusions] Only by the operating method can the peritoneum be pulled easier, the bladder be disturbed poorly, and the operation be easier.