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，哪些人需要做腹腔镜？

　　Infertility, which people need to do laparoscopy?

　　1）输卵管性不孕者：如输卵管粘连、阻塞、积水等，可以通过手术分离粘连、疏通输卵管，以期恢复输卵管功能，达到自然妊娠的目的；

　　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）子宫内膜异位症：子宫内膜异位包括卵巢型、盆腔腹膜型、DIE等，卵巢型及DIE可以通过常规的妇科检查、影像学检查等明确诊断，但腹膜型的子宫内膜异位症自能通过腹腔镜明确诊断，同时还可以去除肉眼可见的病灶，是子宫内膜异位症的金标准；

　　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）子宫肌瘤：子宫肌瘤是否需要手术主要取决于肌瘤的大小和生长部位。一般粘膜下肌瘤无论大小、大于4厘米的肌壁间肌瘤、大于7厘米的浆膜下肌瘤都有可能影响怀孕，具备手术指征。如果肌瘤贴近内膜引起宫腔变形，或距内膜<0.5厘米且能除外其他不孕原因，也可以考虑手术切除子宫肌瘤；

　　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）宫外孕：不孕症的病人妊娠后发生宫外孕的几率高于正常人群，不具备保守治疗条件的病人，如果腹腔内出血少，生命体征平稳可以通过腹腔镜手术治疗；

　　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）卵巢病变的诊断及治疗：如卵巢子宫内膜异位囊肿、畸胎瘤等，多囊卵巢综合征的卵巢打孔手术已经很少应用；

　　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）腹腔镜手术还可以在检查同时行输卵管通液术，是诊断输卵管病变的金标准；

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

　　7）腹腔镜联合宫腔镜手术：可以用于输卵管间质部阻塞的疏通以及提高宫腔镜手术的安全性；

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

　　8）体外受精-胚胎移植的病人：术前处理盆腔病变，可以大大提高胚胎的种植率；

　　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：通过腹腔镜检查可以发现常规检查无法诊断的盆腔病变并给予相应处理，增加怀孕的机会。

　　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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