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1、感谢您的阅览感谢您的阅览经阴道无张力尿道中段吊带术TVT术TVT微创伤手术1.1. 减少手术时间减少手术时间 Reduce surgical timeReduce surgical time 2.2. 减少住院时间减少住院时间 Reduce length of hospitalization Reduce length of hospitalization 3.3. 减少并发症减少并发症 Reduce complication rates/risksReduce complication rates/risks 4.4. 复原快复原快 Allow quicker return to norma
2、l, daily activitiesAllow quicker return to normal, daily activities5.5. 减少费用减少费用 Lower costsLower costs GYNECARE TVT Tension-free Support for IncontinenceGYNECARE TVT Tension-free Support for IncontinenceTVT尿失禁的无张力支撑尿失禁的无张力支撑简介 ITVTTVT尿失禁的无张力支撑是一种创新的微创伤手术方法尿失禁的无张力支撑是一种创新的微创伤手术方法, , 它对张它对张力性尿失禁治疗的有效性
3、已得到了充分的临床证明力性尿失禁治疗的有效性已得到了充分的临床证明GYNECARE TVT Tension-free Support for Incontinence is an innovative minimally invasive GYNECARE TVT Tension-free Support for Incontinence is an innovative minimally invasive surgical alternative for the effective treatment of stress urinary incontinence, with surgica
4、l alternative for the effective treatment of stress urinary incontinence, with proven resultsproven results使用Prolene网带进行无张力尿道中段悬吊术 The placement of a The placement of a piece of PROLENE mesh (45 cm x 1.1 cm x 0.7 mm) without tension, at the mid piece of PROLENE mesh (45 cm x 1.1 cm x 0.7 mm) without
5、 tension, at the mid urethraurethraGYNECARE TVT Tension-free Support for IncontinenceGYNECARE TVT Tension-free Support for Incontinence TVT尿失禁的无张力支撑尿失禁的无张力支撑简介 II局麻局麻, , 阻滞阻滞/ /硬膜外硬膜外Local anesthesia,sedation/regionalLocal anesthesia,sedation/regional经阴道进路，切口小切口小, , 分离少分离少 Minimal incisions and diss
6、ectionMinimal incisions and dissection 网带无张力地置于尿道中段下网带无张力地置于尿道中段下Tape placed at mid urethra without tensionTape placed at mid urethra without tension 普理灵聚丙烯网带无需和任何组织固定 No fixationNo fixation术中使用膀胱镜术中使用膀胱镜 Cystoscopy performedCystoscopy performed 术后插尿管时间短术后插尿管时间短 Infrequent use of post-op cathetersIn
7、frequent use of post-op catheters 可在门诊进行，当天出院可在门诊进行，当天出院 Discharge home the same dayDischarge home the same day Goal of SurgeryGoal of Surgery手术目的1. 1. 修复和修复和/ /或加强阴道尿道韧带或加强阴道尿道韧带 Restore and/or reinforce the pubourethral Restore and/or reinforce the pubourethral ligaments.ligaments. 2.2.修复和修复和/ /或加
8、强尿道下阴道吊筋膜或加强尿道下阴道吊筋膜 Restore and/or reinforce the Restore and/or reinforce the suburethral vaginal hammocksuburethral vaginal hammock3.3.加强尿道旁结缔组织加强尿道旁结缔组织 Reinforce the paraurethral connective tissueReinforce the paraurethral connective tissue GYNECARE TVT Tension-free Support for Incontinence Indi
9、cationsGYNECARE TVT Tension-free Support for Incontinence Indications TVT尿失禁的无张力支撑尿失禁的无张力支撑适应症适应于以下原因引起的女性张力性尿失禁Intended to be used Intended to be used for treatment of Female Stress Urinary Incontinence resulting fromfor treatment of Female Stress Urinary Incontinence resulting from 尿道过度活动尿道过度活动 ur
10、ethral hypermobilityurethral hypermobility尿道括约肌损伤尿道括约肌损伤intrinsic sphincter deficiencyintrinsic sphincter deficiencyGYNECARE TVT ContraindicationsGYNECARE TVT Contraindications TVT尿失禁的无张力支撑尿失禁的无张力支撑禁忌征怀孕病人 Pregnant patientsPregnant patients 未完成发育的病人 Patients withPatients with future growth potential
11、future growth potential计划要怀孕的病人 Women with plans for future pregnancyWomen with plans for future pregnancyGYNECARE TVT Tension-Free Support for Incontinence SystemGYNECARE TVT Tension-Free Support for Incontinence System TVT产品系列TVT 网带 GYNECARE TVT DeviceGYNECARE TVT Device 推针器 GYNECARE TVT Introduce
12、rGYNECARE TVT Introducer 导引杆 GYNECARE TVT Rigid Catheter Guide GYNECARE TVT Rigid Catheter Guide GYNECARE TVT Tension-free Support for IncontinenceGYNECARE TVT Tension-free Support for Incontinence Description: PROLENE*polypropylene mesh covered by a plastic sheathProlene*网 带: 网 状 钩 形 编 织 , 外 面 套 有
13、塑 料 膜 Prolene*网 带TVT网带 长45公分, 宽一公分的网带, 成分为聚丙烯网带的两侧边有特意编制的毛刺, 增加其在腹壁中的摩擦力, 将带子固定在腹壁中 外面包有一层塑料套, 塑料套在中间分开 网带的两头分别为长30公分, 直径为5毫米的针. 手术中, 针通过阴道前壁切口, 带着网带穿过腹壁, 使其置于尿道中段下网带的网眼大小适中, 术后结缔组织会长在网眼中, 加强盆底的组织 Prolene 普理灵特点惰性强组织相容性强/组织反应小有延展性表面光滑易于操作心血管吻合的专用缝线,在缝合材料中有“缝线之王”的称号GYNECARE TVT IntroducerGYNECARE TVT
14、Introducer 推针器推针器 推针器的方形头部结在真的方形尾部, 手术中, 术者的手握住推针器的T形手柄, 帮助针顺利穿过腹壁 GYNECARE TVT Rigid Catheter GuideGYNECARE TVT Rigid Catheter Guide 导引杆导引杆导引杆在手术中的作用主要是推开膀胱, 防止穿针过程中产生膀胱穿孔 它从18号导尿杆进入膀胱, 从左侧穿针, 就将膀胱推向右侧, 反之亦然 GYNECARE TVT Patient InformationGYNECARE TVT Patient Information病人情况手术介绍 Procedure overview
15、Procedure overview病人手术风险Potential risksPotential risks血肿血肿 B Bleeding-hematoma formationleeding-hematoma formation感染感染 InfectionInfection 膀胱穿孔膀胱穿孔 Bladder perforationBladder perforation尿潴留尿潴留 Urinary retentionUrinary retention排斥反应排斥反应 Mesh erosion or rejectionMesh erosion or rejection复原 RecoveryReco
16、very期望 ExpectationsExpectationsGYNECARE TVT - Pre OpGYNECARE TVT - Pre OpTVT 术前 术前抗菌素 Peri-operative antibioticsPeri-operative antibiotics停止使用抗凝剂 Cessation of anti-coagulants Cessation of anti-coagulants Instrument Requirements手术需要的器械阴道重锤/拉钩弯剪-分蚊式钳 - 钳住塑料套, 抽出.长的硬膜外针头-局麻70度膀胱镜 - 观察膀胱情况18号(单枪/双枪)导尿管GYNECARE TVT - ProcedureGYNECARE TVT - Procedure手术过程病人准备 Patient preparationPatient preparation 切口 IncisionsIncisions分离，穿针，放置网带 Dissection, needle passage and tape placementDissection, needle passage a
