Clinical Study On The Pressure Detection And Repair Of The Pelvic Fascia Defect Under Laparoscopy

ObjectiveTo investigate the feasibility of carbon dioxide pneumoperitoneum and uterus lifting cup mobile formation pressure detection in the basin fascia defect by means of laparoscopic;evaluation on laparoscopic pressure detection judgment in the basin fascia defect repair of clinical therapeutic effect.MethodsSelection of 30 patients with pelvic organ prolapse treated by surgical treatment from September 2013 to September 2014 in Affiliated Hospital of Tai shan Medical College,who were diagnosed as pelvic organ prolapse by the method of quantitative score(POP-Q)of pelvic organ prolapse.The location of the defect in patients could be judged by the clinical evaluation of Petros integrated theoretical system(Graphical diagnostic method-physical examination to determine damage-simulation operation)before operation.Surgical treatment was performed in 30 patients.The operation was performed under laparoscopy,during the operation,with the aid of the pressure of the formation of carbon dioxide pneumoperitoneum and uterus lifting cup mobile and endopelvic fascia defect sites under pressure because of local weak will form a signi-ficant depression,observe the location and size of the depression and repair the sunken area.Follow up by 6 weeks,6months and 1 years and every six months after operation.The subjective effect was evaluated by the short form of pelvic floor distress inventory(PFDI-20),analyzed the changes of the position of the POP-Q before and after the operation and the complications.Results1.In this study,30 patients were compared and analyzed according to the Petros overall theory of clinical evaluation of the method to determine the defects of the pelvic fascia defect site and the pressure of the laparoscopic detection of the defect site,the data using paired samples t test,the results showed P>0.05,the difference was not statisticallysignificant.so the defect site of the pelvic fascia defect which was judged by the Petros integral theory and clinical evaluation method was basically the same as that of the defect site under the pressure of laparoscopy.Pressure detection under the laparoscopic of the pelvic fascia defect is more intuitive,can accurately determine the location and the size of the defect.2.The average operation time was(128.56± 1.28)min,mean intraoperative blood loss(80.79±9.45)ml,30 cases were taken in this study.The average time of indwelling catheter(4.45 ± 1.68)d.No patients required long-term catheterization;1 cases of discharged patients,residual urine volume>100ml,by strengthening the bladder functional training and bladder training returned to normal,the ultrasound review without residual urine volume.The mean postoperative exhaust time was(29.36±3.36)h,and the average hospital stay was(6.61±2.45)d.1 cases had postoperative pelvic infection,and improved after conservative treatment.3.In this study,30 patients,6 weeks,6 months,1 years and 2 years of POP-Q points(Aa,Ba,C,Ap,Bp)were significantly higher than the preoperative,were basically restored normal anatomical position,the difference was statistically significant,(P<0.05);There was no significant difference in each stage after operation(P> 0.05);And there was no significant difference in TVL at each stage after operation,and the difference was not statistically significant(P>0.05).The cure rate of anatomy in the near future was 96.7%(29/30).4.In the 30 patients,the symptom scores were significantly lower than the preoperative,the difference was statistically significant(P<0.05);The lower the operation time,the lower the symptom score,the scores of symptom at the last follow up were lower than the initial follow up,the difference was statistically significant(P<0.05).ConclusionThe pressure detection of the pelvic fascia under laparoscopy can determine the location and the size of the defect,and can repair the defect,the effect was obvious,and the postoperative complications were few.The defect site in pelvic fascia be determined by the Petros overall theory of clinical evaluation method and be detected by the pressure of the laparoscopic is basically consistent,and can play a guiding significance to finding the defects in the operation of the site.