Recently, the team of Director Liu Wei of the Second Gynecology Ward of our hospital successfully removed a huge pelvic mass with a diameter of about 20cm with only a 2cm incision, which solved the physical and psychological burden for the patient.
46-year-old Ms. Wang (pseudonym) visited the ** outpatient clinic of our hospital for "intermittent lower abdominal pain for 5 months", and Director Liu immediately arranged relevant examinations for the patient, which showed that Ms. Wang had a huge pelvic mass with a diameter of about 20cm in her pelvis. Ms. Wang said that she had never had a physical examination, and she only felt that she had gained weight recently, and she never thought that such a huge lump had grown in her stomach.
After admission, a pelvic MRI examination was performed for the patient, suggesting a large pelvic mass that considered ovarian teratoma.
Figure 1 Pelvic MRI Figure 2 Pelvic MRI.
According to the previous technology, this kind of huge pelvic mass usually requires laparotomy, and the laparotomy is large, the postoperative recovery is slow, the hospital stay is long, and it is not beautiful. After the ** of Director Liu Wei's team, a transumbilical single-port laparoscopic surgery was formulated for the patient, and only a 2cm inclement in the umbilicus was needed to complete the operation. This surgical method can not only remove the tumor completely, but also almost completely invisible surgical scar after surgery, but this surgical operation angle is zero, which requires a high level of experience and skills of the surgeon. Ms. Wang's operation was very successful, the tumor was found in the right ovary, the size was about 20 15cm, and the pedicle of the mass was torsioned for 2 weeks, Director Liu performed transumbilical single-port laparoscopic right adnexectomy for the patient, the postoperative pathology was ovarian mature cystic teratoma (benign lesion), the patient recovered well after surgery, he could get out of bed on the day after surgery, and the next day he was vented, and the umbilical incision healed well, and he was successfully discharged.
Figure 3: Healing of the umbilical incision on the second day after surgery.
Science. Most ovarian cysts are benign tumors, and most patients have no obvious normal when they are small, usually found during physical examination, with the increase of the mass may appear compression symptoms, and some patients will have cyst torsion, rupture, infection, and even the possibility of developing malignant tumors. Therefore, I would like to remind the majority of female compatriots that they must have regular physical examinations, and follow up closely if abnormalities are found, so as to achieve early detection, early diagnosis, and early detection.
** of ovarian cysts: 1Expectation**: Asymptomatic ovarian cysts before menopause are mostly functional cysts, which need to be observed and followed-up, if the cysts regress on their own or have no changes, there is no need**; If the cyst does not disappear or continues to enlarge, a physiological cyst is excluded and can be surgically operated**; If the cyst is larger than 10 cm in diameter, surgery is recommended**. 2.Surgery**: For symptomatic benign ovarian cysts before menopause, ovarian cystectomy is recommended, and unilateral nearby resection and contralateral salpingectomy or bilateral salpingectomy are recommended after menopause.
Transumbilical single-port laparoscopic surgery is to make an incision about 2cm long in the umbilicus, and after the operation is completed, the incision is hidden in the umbilical fold, and the surgical scar is almost invisible after healing, and the "scar-free" operation is realized. Compared with the traditional multi-port laparoscope, the transumbilical single-port laparoscope is more minimally invasive, with less incision to one, less postoperative pain and faster recovery. And the transumbilical single-port laparoscope has an incision protective sleeve, which makes it easier to take out the specimen, especially for the removal of uterine or fibroid specimens, the large tissue can be taken out continuously by the method of "rotary cutting apple peel", avoiding the use of rotary cutter, which can not only reduce the risk of planting and dissemination, but also reduce the organ damage caused by the rotary cutter.
Text|Second Department of Gynecology Shi Jiaqi.