Laparoscopy is to round the dream of a family with children, so that infertility patients ignite new hope, have a happy and beautiful family is everyone's wish, the existence of laparoscopy is very important! I often hear doctors talk about all kinds of "mirrors": gastroscopy, enteroscopy, cystoscopy, hysteroscopy, laparoscopy and so on. "Mirror" as the name implies, is used to see, laparoscopy is used to see the interior of the abdominal cavity. The common pneumoperitoneum laparoscopy needs to inject air into the abdominal cavity after abdominal puncture, so that the abdomen expands to form a space, and then put into the monitoring mirror, as a laparoscopic video system, real-time display of the situation in the abdominal cavity through the bedside display, acting as the doctor's eye, the doctor can fully understand the actual situation of the patient's abdominal cavity, and take corresponding treatment measures. 2-4 operation holes with a diameter of 0.5-1.0 cm should be pierced on the abdominal wall after placing the mirror, which is used to place the operating instruments and deal with the lesions. What's going on with laparoscopy?
              

　　不孕，哪些人需要做腹腔鏡？

　　Infertility, which people need to do laparoscopy?

　　1）輸卵管性不孕者：如輸卵管粘連、阻塞、積水等，可以通過手術分離粘連、疏通輸卵管，以期恢復輸卵管功能，達到自然妊娠的目的；

　　1) Tubal infertility: such as tubal adhesion, obstruction, hydrosalpinx, etc., can be separated and dredged by surgery in order to restore the function of fallopian tube and achieve the purpose of natural pregnancy;

　　2）子宮內膜異位癥：子宮內膜異位包括卵巢型、盆腔腹膜型、DIE等，卵巢型及DIE可以通過常規的婦科檢查、影像學檢查等明確診斷，但腹膜型的子宮內膜異位癥自能通過腹腔鏡明確診斷，同時還可以去除肉眼可見的病灶，是子宮內膜異位癥的金標準；

　　2) Endometriosis: Endometriosis includes ovarian type, pelvic peritoneum type, die, etc. ovarian type and die can be diagnosed by routine gynecological examination and imaging examination, but peritoneal endometriosis can be diagnosed by laparoscopy, and the visible lesions can be removed, which is the gold standard of endometriosis;

　　3）子宮肌瘤：子宮肌瘤是否需要手術主要取決于肌瘤的大小和生長部位。一般粘膜下肌瘤無論大小、大于4厘米的肌壁間肌瘤、大于7厘米的漿膜下肌瘤都有可能影響懷孕，具備手術指征。如果肌瘤貼近內膜引起宮腔變形，或距內膜<0.5厘米且能除外其他不孕原因，也可以考慮手術切除子宮肌瘤；

　　3) Uterine leiomyoma: whether uterine fibroids need surgery depends mainly on the size and growth site of the fibroids. In general, submucosal myoma, no matter its size, intramural myoma larger than 4cm, and subserosal myoma larger than 7cm, may affect pregnancy, and have surgical indications. If the myoma is close to the endometrium and causes uterine cavity deformation, or is less than 0.5 cm away from the endometrium and other infertility causes can be excluded, surgical resection of uterine fibroids can also be considered;

　　4）宮外孕：不孕癥的病人妊娠后發生宮外孕的幾率高于正常人群，不具備保守治療條件的病人，如果腹腔內出血少，生命體征平穩可以通過腹腔鏡手術治療；

　　4) Ectopic pregnancy: the rate of ectopic pregnancy in infertile patients is higher than that in normal people. Patients without conservative treatment conditions can be treated by laparoscopic surgery if there is less intra-abdominal bleeding and stable vital signs;

　　5）卵巢病變的診斷及治療：如卵巢子宮內膜異位囊腫、畸胎瘤等，多囊卵巢綜合征的卵巢打孔手術已經很少應用；

　　5) Diagnosis and treatment of ovarian lesions: for example, ovarian endometriosis cyst, teratoma, ovarian drilling surgery for polycystic ovary syndrome has been rarely used;

　　6）腹腔鏡手術還可以在檢查同時行輸卵管通液術，是診斷輸卵管病變的金標準；

　　6) Laparoscopic surgery can also perform tubal hydrotubation at the same time, which is the gold standard for the diagnosis of tubal lesions;

　　7）腹腔鏡聯合宮腔鏡手術：可以用于輸卵管間質部阻塞的疏通以及提高宮腔鏡手術的安全性；

　　7) Laparoscopy combined with hysteroscopy: it can be used to dredge tubal interstitial obstruction and improve the safety of hysteroscopic surgery;

　　8）體外受精-胚胎移植的病人：術前處理盆腔病變，可以大大提高胚胎的種植率；

　　8) In IVF-ET patients, the implantation rate of embryos can be greatly improved by preoperative treatment of pelvic lesions;

　　9）不明原因不孕的患者：通過腹腔鏡檢查可以發現常規檢查無法診斷的盆腔病變并給予相應處理，增加懷孕的機會。

　　9) Patients with unexplained infertility: laparoscopic examination can find pelvic lesions that can not be diagnosed by routine examination and give corresponding treatment to increase the chance of pregnancy.

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