【摘要】 目的　探讨腹腔镜下改良Vechitti阴道成形术的临床应用价值。方法　对 18例先天性无阴道无子宫患者实施腹腔镜下改良Vechitti阴道成形术 ,膀胱与直肠间隙不造穴 ,用硬膜外穿刺针或特制长针 ,由前庭凹陷直接穿刺 ,经膀胱与直肠间隙穿入腹腔 ,引入两根牵拉线 ,牵拉线再由前腹壁引出 ,外阴部牵线固定一直径 2 0～ 2 5cm纽扣 ,自腹部逐日拉紧提线 ,纽扣使前庭上升形成阴道。结果　 18例成形之阴道宽敞 ,黏膜粉红色 ,有皱壁、润滑、弹性好 ,外阴外观无改变 ,性生活满意。 1例术后放置阴道模型时骑自行车致阴道直肠瘘。结论　对先天性无阴道无子宫患者采用腹腔镜下改良Vechitti阴道成形术创伤小 ,操作简易 ,有推广价值。更多还原

【Abstract】 Objective To investigate the clinical effect of improved laparoscopic Vechitti procedure for constructing a functioning vagina . Methods By using the method of raising vestibular mucosa,18 patients with congenital absence of vagina and uterus underwent surgery in our hospital. No cave was made between bladder and rectum. The procedure involved puncturing the vulvar vestibulum pit with an epidural paracentetic needl or specially-made needle into abdominal cavity through rectovesical interspace,two drag-lines was introduced through anterior abdominal wall,using the line to tie a clothes button of 2.0～2.5cm diameter to the vulva,rasing the lines day by day,the vestibule go upward along with the button,then the vagina was formed. Results After the procedures,the artificial vagina of all 18 patients could hold a speculum and the mucosa appeared soft and smooth with normal lubrication. The vulvar tissues appeared uninjured and normal in all cases. The married patients were satisfactory to the intercouse. One case of vagino-rectal fistula was observed in a patient after she rode a bicycle with the vaginal mould . Conclusion The improved laparoscopic Vechitti procedure for constructing a functioning vagina has less trauma than conventional operation and is easy to operate. Therefore,the new improved procedure is a preferred way in constructing vagina for treating those patients. ;更多还原