subtotal hysterectomy

1. Uterine fibroids, functional bleeding of the uterus, adenomyosis of the uterus, normal cervical examination, the patient is required to preserve the cervix. 2. The uterus needs to be removed for various reasons, but it is difficult to remove the cervix. Treatment of diseases: uterine fibroids Indication 1. Uterine fibroids, functional bleeding of the uterus, adenomyosis of the uterus, normal cervical examination, the patient is required to preserve the cervix. 2. The uterus needs to be removed for various reasons, but it is difficult to remove the cervix. Preoperative preparation Cervical smear and diagnostic curettage were performed before surgery to exclude cervical and uterine malignant tumors. Surgical procedure 1. Incision: a median incision in the lower abdomen or a transverse incision in the pubis. 2. Exploring: Understand the size, activity and cervix of the uterus. 3. Cut the round ligament: clamp the uterine horn on both sides and pull it outside the abdominal cavity. The ligament was cut at a distance of 1 cm from the uterine horn and the distal end was sewed. 4. Treatment of attachments: The ovary intrinsic ligament and the interstitial part of the fallopian tube were cut by the Gongjiao clamp, and the "8" word was sutured. 5. Exposure of the lower uterus: open the anterior lobe of the broad ligament along the sides of the uterus and the bladder reflexes the peritoneum. Lift the bladder to reverse the peritoneum, in the loose tissue gap between the bladder fascia and the cervical fascia, separate the bladder down to the uterine isthmus, and then cut the posterior lobe of the broad ligament to the uterine isthmus along both sides of the uterus. 6. Treatment of uterine blood vessels: at the level of the uterine isthmus close to the uterine wall clamp to cut the uterus, veins and para-uterine tissue, stump suture. 7. Resection of the uterus: Open the bladder, expose the isthmus of the uterus, make a circular incision in the isthmus, run through the mucosal layer of the cervical canal, and cut out the uterus. After disinfection of the cervical stump, suture with the absorbable line "8". 8. Reconstruction of the peritoneum: suture the peritoneum of the pelvic pelvis, embedding the bilateral attachment end, the round ligament end, and the cervical stump. 9. Closing the abdomen: layering the layers of the abdominal wall.