![新编妇科手术图谱](https://wfqqreader-1252317822.image.myqcloud.com/cover/534/23313534/b_23313534.jpg)
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0001.jpg?sign=1739548781-rg398msaMcorPef2T6WMPNCoA61WhF1h-0-3f562509f1f7ae46b47a4391febda22e)
版图4-1 输尿管逆行造影显示狭窄部位
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0002.jpg?sign=1739548781-V0JTbDKzKHxio4RyjPvhkMGGLxRe80Su-0-2bab35e4682bac681dfbf6548d5a379e)
版图4-3 充气后见蜂腰征
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0003.jpg?sign=1739548781-6blaGlXOO1xSInqHxqbEOOuMp4OvDClR-0-1f869085094000ea0f06e84a29c28574)
版图4-2 插入气囊导管
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0004.jpg?sign=1739548781-l3uNdcSsqxUr5w8ETtGOOyuiTcjdA9Q8-0-211146451ef8274e50fedf8f73ca9c84)
版图4-4 充气至蜂腰征消失
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0005.jpg?sign=1739548781-y9YlXYgGfaXHU7Qfw0UCn2PEU7AjWvio-0-a7e6ec802ce3c0b76ca80e4743e90a15)
版图5-1
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0004_0001.jpg?sign=1739548781-QDeMfjxRwbnaIPgnSADYPrfl4HeyWZZR-0-926c33fe310585c34d3b0d61aa66e31e)
版图5-2 A在宫旁组织中游离子宫深静脉,B示宫旁组织中的子宫深静脉
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0004_0002.jpg?sign=1739548781-r9V09dP89P1QnkC9ZCI7E5wViK0H9Jja-0-ffa892bfa0753ea4cefd8977803c2fc5)
版图5-3 A分离盆腔内脏神经上方的子宫深静脉,B示子宫深静脉下方的盆腔内脏神经
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0004_0003.jpg?sign=1739548781-9gZk46BoLjlP5lOlePYYZ8X70dyTNoWR-0-a3e86fdbb454258f19169f8ee568dac0)
版图5-4 A在直肠旁间隙直肠侧分离腹下神经,B示腹下神经
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0004_0004.jpg?sign=1739548781-AE7AESbCJhoRDKXUnv8m3QSUl3Vk4HGp-0-cd101ed225e8e29aec39fdff69d3793f)
版图5-5 A分离膀胱宫颈韧带后叶中的膀胱中静脉,B示膀胱中静脉
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0005_0001.jpg?sign=1739548781-RR53n3tNIRaI7Jcrt8ZJAfWlPvncwWzr-0-ce49098bd14cd05a9d213dc6c5d42ee8)
版图5-6 A游离膀胱下静脉,显示其下方的下腹下神经丛膀胱支,B示膀胱下静脉与下腹下神经丛膀胱支的关系
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0005_0002.jpg?sign=1739548781-ALAd8imiojMyDr3VcnhtFZ5NLGQpgaVM-0-4dee438e3a178bba2d130977aa451045)
版图5-7 A从下腹下神经丛中分离出腹下神经、盆腔内脏神经、膀胱支及子宫支,B示下腹下神经丛
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0005_0003.jpg?sign=1739548781-ylDEstUOO0BeRDhPDb9SAY6eNOdJVtfR-0-42f6070aa3eb226ce0220c8c4d6b61c9)
版图5-8 A分离出下腹下神经丛的子宫支,B示从下腹下神经丛中分离子宫支
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0005_0004.jpg?sign=1739548781-0yhe43WxiMvQ8sO8xqoLx2FgCkggUM9L-0-3f0bf353d40f779faf13a0fc20e8c42a)
版图5-9 A分离下腹下神经丛的子宫支,显示出T形平面,B示下腹下神经丛的子宫支断端
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0006_0001.jpg?sign=1739548781-J1DfWsrEAbBnCdSFVoETlp29wHEp0Onj-0-a1aa384cd318fd7bc3e0af66a791bf52)
版图5-10 A钳夹阴道旁组织,显示出下腹下神经丛的膀胱支,B示阴道旁组织与膀胱支的关系
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0006_0002.jpg?sign=1739548781-YsrM4dmr9HliQhPFxlcK5xIblH4Ep5gK-0-2d9091b829a226e81c9cb80657ed5d38)
版图5-11 A分离阴道旁组织,保留下腹下神经丛的膀胱支,B示阴道旁组织断端及保留的膀胱支
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0006_0003.jpg?sign=1739548781-0ySQ7YCCJucxA9CRxlrksfGvzYD96MIj-0-b5e4316cd2bbb13c0d6c04b0a48f7609)
版图5-12 切除子宫后的T形神经平面示意图
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0001.jpg?sign=1739548781-zYe5BAttPBrAAY9F8vqrUFJeiyluXrHq-0-e48349a2178adc7a9297bb94db0fcacd)
版图5-13 病灶直径小于2cm的根治性子宫颈切除术范围
1.根治性子宫切除术范围 2.根治性子宫颈切除术范围
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0002.jpg?sign=1739548781-khIck7pcZXpbkwXxtg64CGuKdddSuXTo-0-0df347390e738afdbb822c99a0a9cdcb)
版图5-14 病灶直径2~4cm的根治性子宫颈切除术范围
1.根治性子宫切除术范围 2.根治性子宫颈切除术范围
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0003.jpg?sign=1739548781-IQmf66EFZIhQb8vO27bJ0Dojl2HzRh5J-0-5d4954163c1b54f5f291a8803f28810a)
版图5-15 分离直肠侧间隙
1.输尿管 2.直肠侧间隙
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0004.jpg?sign=1739548781-mFoSrspyATmHmQZHiEi1DHewDEM8l5Us-0-eb78c56754e0795e94254cef5f8ac173)
版图5-16 分离直肠阴道间隙
1.右骨盆漏斗韧带 2.子宫直肠间隙腹膜 3.左骨盆漏斗韧带
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0005.jpg?sign=1739548781-of5fsHQOXHo1HD52VHNtt3v4fP6dC5F8-0-1b2e32ea6844c642fe8b8a7541f6c221)
版图5-17 切除1/2的骶骨韧带
1.骶骨韧带深层 2.直肠
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0006.jpg?sign=1739548781-WJK7eewlcXEZvwcBGsIuQpWaBwCE3Phh-0-e968b4831496c4d3174e71607ee64efd)
版图5-18 分离膀胱宫颈间隙
1.疏松组织间隙 2.膀胱宫颈间隙
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0007.jpg?sign=1739548781-S25v4IiYgOhEAoqDsaClfTVtUjeyQQ1y-0-4fb87601415e1e2e816a78301f8cb6e0)
版图5-19 在输尿管下方打开输尿管隧道
1.输尿管 2.子宫动脉 3.输卵管系膜
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0007_0008.jpg?sign=1739548781-toeQCFyyxYKR3XjNkmdXz9pdbuVsbKFf-0-e05ba3fb16f9d074a37f70ed050c5786)
版图5-20 钝锐结合分离子宫动静脉暴露主韧带
1.子宫动静脉周围的疏松结缔组织 2.子宫动脉 3.输尿管 4.髂外静脉
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0001.jpg?sign=1739548781-u6ko6vwKglX30riPmsjjSyPmyX37ORyN-0-a936d43ab75fb71055fcc045bf5237dc)
版图5-21 切断右侧主韧带观察主韧带周围的解剖
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0002.jpg?sign=1739548781-WB7Bj8xtNVxsa9xwcvU9blXscK8G8dt9-0-27888f342433e2919f420e091efc0aae)
版图5-22 观察各组织器官解剖位置保留子宫动静脉
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0003.jpg?sign=1739548781-jwUralJl1vQQ3sejYc7ItMMCgtY6eaUR-0-93f12d1820f9b08b89ab6f362b2d69a1)
版图5-23 切除3cm的阴道
1.阴道前壁 2.阴道后壁 3.阴道断端
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0004.jpg?sign=1739548781-3QMnRUoFuUCxB8oPOLGwYQ1Sl0RBHoMC-0-1e360dc2be252dbef0e6338f7d9fa296)
版图5-24 保留子宫动脉上行支
1.子宫动脉 2.输尿管 3.膀胱 4.宫颈部 5.髂外静脉
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0005.jpg?sign=1739548781-99Nl8yoen1ttZMD2FYGGw9OKPL28rJ87-0-d5039331df867a03764a0c86d2e5f2cb)
版图5-25 横断宫颈
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0006.jpg?sign=1739548781-r0byD4Cdo06Kh2UQkSQYWceTfcpicSye-0-c939fd709db0ff0a1e940f3131266729)
版图5-26 固定在节育环的橡胶管预防宫颈口粘连
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0007.jpg?sign=1739548781-FAR1N3wrWYqC6o9lAcQEzjMDHvckfs1z-0-268824a99d16b1334a59a0fda2542bde)
版图5-27 用补片环绕宫颈外口预防宫颈外口松弛
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0008.jpg?sign=1739548781-VDL3yQ0Ty5rIs3AP6yFbO9pA46Jr3wZk-0-baa8ab058be641c2ac921b3cfb05036d)
版图5-28 将阴道壁缝合在宫颈外侧术后4周的宫颈外观
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0001.jpg?sign=1739548781-OzosmPTmo4w2xYiNKQkW0dd3QGtIKOCM-0-2c4ee70963aea2b9a0b3e4cc0e8a834a)
版图5-29 缝合阴道时阴道壁要盖住宫颈的环形补片
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0002.jpg?sign=1739548781-LGxZ77aiIfIUEpTwa3JIYjomV5Mud6PV-0-2487d5d7ee94532b309168fb4cf6e78d)
版图5-30 将两片聚丙烯网片形成人工主韧带和骶韧带
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0003.jpg?sign=1739548781-zRtkY9gIjRfkDiKfUt4vZgk6eV7vboIt-0-94d7b9d1d88071ac368ae98a3bf25ba9)
版图5-31 将聚丙烯网片缝合固定在子宫下段后壁
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0004.jpg?sign=1739548781-zorkVzsktwVwx2iyuE7jveTu72vvWjxU-0-b8285966cda29c80e43a2944743f7f61)
版图5-32 聚丙烯网片与骶韧带和主韧带的断端相接
1.人工骶韧带 2.子宫 3.人工主韧带
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0005.jpg?sign=1739548781-JjmprqKR6xIacrtnHYzcggJ19EhxitW6-0-149792f7eda58139ea2a4f5526e12121)
版图5-33 关闭盆腹膜,预防补片外露
1.膀胱反折腹膜 2.子宫浆膜
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0009_0006.jpg?sign=1739548781-UU7y23PPwatkWcPAM1XPVjcPEwMVidQ2-0-58b1b171f649bd30b39059896aac650d)
版图11-1 诺舒手术前宫腔镜下宫腔形态
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0001.jpg?sign=1739548781-OIh6DxmC8RdhYUuL3ceCZff6svV32Lot-0-1d62fdbf1e3ac6bc469b6f485dab2766)
版图11-2 舒展电极附于子宫内膜表面
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0002.jpg?sign=1739548781-scRmBDFnUDPrspCU8BZh6RL1ZvQNIbdA-0-ad1b9fd7bc755539d6efd048ec4e6852)
版图11-3 CO2检测有无宫穿孔
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0003.jpg?sign=1739548781-NhUebdHrwfFGLt68pCoHeEgzAbdlpZI8-0-92667706620b423fa8e150953bf6966f)
版图11-4 诺舒网状电极传输能量切除子宫内膜
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0004.jpg?sign=1739548781-4sErxijNtKxY01PdCWULdEV3y2SSmuxE-0-2901243362df2614e04d8a48a9737342)
版图11-5 术后宫腔表面
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0005.jpg?sign=1739548781-kQMcpLAU8y5HPelEyLHh2WvX7e7s4Otg-0-3b93de013364f4a7f1b7c6f4e1392180)
版图11-6 子宫肌层渗透程度(子宫角:2~3mm;子宫体:5~7mm)
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0006.jpg?sign=1739548781-g3l0M5i7F5NkewQXjkkU1FNfpFefcv4M-0-ad5f5c1767430b7ee430c9b07d493561)
版图11-7 诺舒手术后宫腔镜下宫腔形态
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0007.jpg?sign=1739548781-n0p8rrYtYEunHPjSbfvhVJOSySuCvOnY-0-5886cb00febc5a9b1279dc760738b6bd)
版图11-8 诺舒术后子宫内膜黏附在双极电极上
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0008.jpg?sign=1739548781-SsuzAEjoqjNO2qO3jeNA6TIBiwIbrQ2a-0-2effc2a9109452ce3460782e047202f0)
版图11-9 诺舒手术后子宫标本(子宫大小不同,肌层渗透程度不同,子宫破坏的深度一致)