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1. Artificial pneumoperitoneum
Cut the skin 1cm at the lower edge of the umbilical wheel, insert a pneumoperitoneum needle at a 45-degree angle from the incision, withdraw a needle after no blood is drawn, and if the normal saline flows smoothly, it means the puncture is successful and the needle is in the abdominal cavity. Connect the CO2 inflator, the air intake speed should not exceed 1L/min, and the total amount should be 2-3L. The intra-abdominal pressure does not exceed 2.13KPa (16mmHg).
2, trocar puncture
The laparoscope needs to be inserted into the abdominal cavity from the cannula, so the trocar needs to be inserted first. The laparoscopic sleeve is thicker, and the incision should be 1.5cm. Lift the abdominal wall below the umbilicus, and slowly insert the trocar obliquely and then vertically into the abdominal cavity. When entering the abdominal cavity, there is a sense of breakthrough. Pull out the cannula core, and insert the laparoscope after hearing the gas rushing out of the abdominal cavity, turn on the light source, and adjust the patient. Position your head down to a 15-degree hip-high position and continue to inflate slowly.
3. Laparoscopic observation
The operator holds a laparoscope and observes the uterus and various ligaments, ovaries and fallopian tubes, rectum and uterine depression with the eyepiece. During the observation, the assistant can move the uterus lifter to change the position of the uterus to cooperate with the examination. If necessary, suspicious lesions can be sent for pathological examination.
4. Take out the laparoscope
After checking that there is no internal bleeding and organ damage, the laparoscope can be taken out. After the gas in the abdominal cavity is exhausted, the cannula is removed, and the abdominal incision is sutured, covered with sterile gauze, and fixed with tape.
5. Post-treatment of laparoscopy:
(1) Antibiotics should be given to prevent infection;
(2) Although the abdominal incision has been exhausted, there may still be residual gas in the abdominal cavity, causing shoulder pain and upper abdominal discomfort, which are usually not serious and do not require special treatment.
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