![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=1738886366-kttTON4l014VmsIVQchEWinfHKVnWhfI-0-98b7f3f7f84b916054669be8548cc7aa)
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=1738886366-PkQ3qY9PITR7V2cm8CIvKcL1WbvNxTVH-0-f5a1b56edb04ae81bc215164133684f5)
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=1738886366-20I4KtWeS8F4ti3l8AIzQmU1JNFoNzqG-0-a27769262adf22608979a380fe794cc0)
版图4-2 插入气囊导管
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0003_0004.jpg?sign=1738886366-0jMVMgblz3T5yu3Kf988dYoLPRC58tXj-0-a5c4b5bdc64b3e3c01e0588b73828696)
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=1738886366-vpWFEM2TOAepATRAg5o21m4WeKCFEsnr-0-2a1892a344af60511742a933059188b7)
版图5-1
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0004_0001.jpg?sign=1738886366-PWRwkxiL3gYtqSoVCn7TbdCbACEvRa40-0-fde9185f6ac31be65c47ebff2376b4b2)
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=1738886366-QWhlR6QurGiUXmUfqcdbeGF8r84Yv4qq-0-67cbb27b1398d9e08240d1ab93c03c7f)
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=1738886366-VzVyn7gPIdM8ZDUKujt6PetFCUBGSbmF-0-34ddf4cb2ac2ed3a282d1d04dcde2a92)
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=1738886366-KvRTboW50CuurTfucGQZ3hpgVpkqdlJ5-0-70ed844bda5ae59fdaea3d3483a6c197)
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=1738886366-mTIS88JmE6j3HmVdP1ZaDELckIc3dV3O-0-b8b322b0ddf267ab4071fbd789384476)
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=1738886366-QAfdPLKD68TWvBkXMjEb6Z2yEVattBmq-0-9988394d4088b5c4d9a3dd2256a4ffae)
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=1738886366-DMb6OZtyiIKrJSf6HVQEaH5XDWxcUQJC-0-40843775133c420745b2a61ac2ca1e0c)
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=1738886366-rHYTEWq0M3pCoxzQdbJad47QzxRqE2KE-0-9131b56d47e07ce998690e6759681a0a)
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=1738886366-869GHU2uwpbCkhvPpQ8uuBjYBxF0aXcJ-0-9410c716e6bedb121d45128584bd5ca5)
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=1738886366-jV4TN9kceZn8LlwXPCw8sfQ5MDQsXT4I-0-bb3a5e7135e7c57d4a90f99a20eb2a90)
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=1738886366-hxV0P8ze7OAT0ooLJmrlpnE5FIvZ1u8l-0-5aae422fb7d656d833200eb4517fc7e4)
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=1738886366-aGwgIvbAW3NOtrLjOwk7467Fmq0S3wB4-0-e94b59314dd8c0934d95a682b14851b8)
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=1738886366-VF3y6Ji7p6NwS5xD5jf3b9qWMtRGXxhY-0-75b5b827c5d172898c6568ead4fb2087)
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=1738886366-i2m58j7DpIkhNk2tpAelMaNxVKnYRFxx-0-a574964fbebee1623d57ebae00e6b7a2)
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=1738886366-8iKQzQlhlcjYYjOrfQ3QMN6LRucrNz5F-0-d140408a336953d14948923fc0787128)
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=1738886366-fTZlU3f7Na5fELBSzS0d2Mymx9uQj2CJ-0-6de9a11f5ae4689dc34e33348cd7b2b1)
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=1738886366-qVPfX5e1XVxWFZkF2lDh4ZmDz1FE8oa6-0-a6fa93edafa25beeecb2f1777acc9723)
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=1738886366-wCLg0Lxz5EGFOxN0GlG2bz7FtBZXiNpy-0-d4c2d6b0e0a71c1a2c1194b9a62777d7)
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=1738886366-41kNUtaqT95FicthubEJKjq0ubei2hX6-0-66d2dea2237aed6747ab0792b2a82caa)
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=1738886366-dVWEW68uOq6KK1DKJOJKbXugALPKwQUn-0-1aa0c2975db5d80a7aab0e21a8b5dbb1)
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=1738886366-KMHXY3wLAGbvWzrUT15VV0tcJiXS8RKH-0-80dda0af0f9f96821f1b432b3badb44b)
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=1738886366-QGHY0vKMwR2UMAePx8cjBDJN7qvZdDVu-0-cc9797bd7f57d796fa6abe3522428108)
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=1738886366-ksOqiKkxdxyVzajosWXnoZwxQObBFU6D-0-5561f70765cdd7fe83058933df45892a)
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=1738886366-twcq59EvepMXhj9NG4rEV03BgtinnpDd-0-20468cccf39ed0916eee41641ab5ba27)
版图5-25 横断宫颈
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0008_0006.jpg?sign=1738886366-HhS2LrO8uGRVOt1vWhYRgDMLZuyQsRTN-0-e842cb3a9d23406f6ceb77cee1f27b3f)
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=1738886366-Q1TUh6XvmvQD51FLCWm04XiJc9PQclts-0-db2878ba48c0bdc8da7361ddb3d7cf02)
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=1738886366-2nXLGa6nraTs1TsWbh8CWL7a6787j1Xd-0-ecbed3456a88e29721011b06d4fb6dac)
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=1738886366-22CRT6722pPiFNBsh1CiYUeAiA3PURFc-0-f0bec1e57df69f1a1c328957457a3124)
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=1738886366-G8SigrZ5MU6isBIBDpDZY0NGIXnIvQfM-0-8f0a285b9b8fd7135220cfc4e94358e8)
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=1738886366-PHO1YW9XPrHKupclhbc9VKSIW9XcrcON-0-0c5943876b805f32fb5f50809a3d883e)
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=1738886366-Ixgzl5u60AIOIplqfcrw06R6JBWyaK7z-0-4d1e2e39388efbcb49250674dad67876)
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=1738886366-9n47I1yb0nBVtCn1YNUwex7uUHavFw57-0-c68deb3ebe1485868a6347f76187f663)
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=1738886366-LyeDcrXj12aChE7VQ6gcmiS4yeU8kprN-0-02b2d9e39f3ceec15fa554162e375cc1)
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=1738886366-0gPRNfoix0UTc4qtiK1WjqkUxR3asJKD-0-90e32dc5b76f728acf70f6a6ce8b9b75)
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=1738886366-1h0uOmIE2Cjruf0w4zVCr6IKemyZMUDI-0-477874484644ccc89949e96ebf4265d8)
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=1738886366-gNDkEPpeQZQvdbVU8vXraOoCQHIYKWoH-0-d76b4569f9c39d66184b3c8d0627b46a)
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=1738886366-drUVOoF9iDJfd99NAyVklGfwxt6YxB4s-0-c3ccc5f59fa98978ed07c3bcb4ca118e)
版图11-5 术后宫腔表面
![](https://epubservercos.yuewen.com/0909FA/11909781304641406/epubprivate/OEBPS/Images/figure_0010_0005.jpg?sign=1738886366-SaxKD9KIUvepshxBVcBL8WcLY87LE1ab-0-e5173109fc9f73be5f976bdfe57e4b21)
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=1738886366-vYPLYUdyc1R4oipiiSEKFHK2fruzFB0f-0-8aaaa99ca362dc58064d053a8944c2a5)
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=1738886366-JVUfB0W8H7dVl5iaZqJTduAU4gsiwIlk-0-e533d673bd7a533234ac80eca29a281b)
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=1738886366-OUPb7zniAuPDUFC7tcPia45qho9pzIER-0-4cf31130e81ae888e9cf289b7043884f)
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)