Desde 1988, quando Harry Reich fez a primeira histerectomia assistida por laparoscopia, muitos de nós trabalharam para o desenvolvimento desta técnica em nosso meio. No final do século passado, disseminou-se mundialmente a técnica de histerectomia assistida por videolaparoscopia como alternativa à via abdominal convencional. Este procedimento utiliza técnicas cirúrgicas laparoscópicas e instrumentos para remover o útero e / ou trompas e ovários através da vagina. Atualmente, a histerectomia é classificada como histerectomia total videolaparoscópica quando ligamento dos vasos uterinos, dos ligamentos uterossacros e ligamentos cardinais, assim como a colporrafia são realizadas por via laparoscópica.
Dentre as diversas técnicas de histerectomia, sugere-se que a técnica intrafascial, histerectomia realizada por dentro da estrutura facial em torno do colo, apresenta vantagens como: manutenção do posicionamento das estruturas de sustentação da cúpula vaginal, manutenção das medidas da vagina e risco diminuído de trauma às estruturas adjacentes, tais como bexiga e ureteres.
O maior desafio talvez tenha sido estabelecer uma técnica cirúrgica padronizada e reprodutível. Discussões sobre o número e o local das punções auxiliares, tipo de energia a ser utilizada e até mesmo os limites do volume uterino para a realização desta técnica permearam o meio científico nestas quase 3 décadas.
Relacionando as vantagens oferecidas pela técnica intrafascial e pela via vaginal na histerectomia, pareceu pertinente associar estes procedimentos ao recurso tecnológico moderno da videolaparoscopia. A associação dos mesmos mostrou-se menos traumática e apresentou vantagens em relação aos procedimentos tradicionais.
Vantagens da via laparoscópica:
As vantagens da abordagem laparoscópica frente à abdominal consistem na ausência de incisão abdominal ampla, menor sangramento e necessidade de transfusões sanguíneas, menores taxas de complicações, menor tempo de internação hospitalar e retorno mais rápido às atividades habituais. Frente à técnica vaginal, as vantagens da via laparoscópica estão na possibilidade de inspeção da cavidade abdominal e diagnósticode patologias associadas, permite a lise de aderências, mobilização segura e remoção de tumores anexiais benignos e secção mais fácil dos ligamentos uterinos redondo e largo.
Indicações e Contra-indicações:
Dentre as inúmeras indicações possíveis, as principais são: miomatose uterina, dor pélvica crônica, endometriose, patologia endometrial benigna, sangramento uterino disfuncional, patologias ovarianas benignas.
Em contrapartida, as contraindicações não são numerosas, sendo elas: situação clínica que não permita a realização do pneumoperitôneo, situação clínica que não permita ventilação adequada durante a anestesia, tamanho uterino que impeça acesso às artérias uterinas, existência de aderências extensas abdominais e pélvicas e prolapso dos órgãos pélvicos tornando mais adequada a via vaginal.
Hoje, temos a certeza de que a histerectomia laparoscópica tem seu espaço consagrado na prática cirúrgica ginecológica graças aos esforços dos pioneiros em nosso meio, mas, acima de tudo, à padronização da técnica.
Estes resultados nos encorajam a postular a disseminação do treinamento de sutura laparoscópica como ferramenta deaperfeiçoamento e desenvolvimento técnico em cirurgia laparoscópica. Ressaltamos ainda a importância da padronização da técnica da histerectomia total laparoscópica, seguindo os preceitos de A. Wattiez, para atingir a excelência neste procedimento. A padronização da técnica cirúrgica da histerectomia total laparoscópica (HTL) permite a realização de uma cirurgia eficaz e segura tanto para cirurgiões experientes quanto para jovens cirurgiões em treinamento.
Fonte: Febrasgo
Hi, its good post on the topic of media print, we all understand media is a fantastic source of data.
Профессиональная автомобильная краска для автомобилей Opel позволяет обеспечить безупречный внешний вид вашего авто. Широкий выбор включает востребованные цветовые коды, такие как Z157, Z163, 2HU и 40R, которые идеально подходят для локального ремонта сколов и повреждений. Для подбора нужного оттенка важно точно определить код краски Opel, который можно увидеть на специальной табличке в автомобиле – на сайте ais-opel.od.ua можно узнать подробно о размещении идентификационной таблички и интерпретации кодов красок Z157, Z163 и других востребованных цветов. Фирменные краски Opel, включая основные покрытия для Astra, Corsa, Vectra, Zafira и других моделей, предоставляют идеальное попадание с заводским цветом и гарантируют высокое качество покрытия при осуществлении кузовного ремонта.
Источник: Коды красок на опель вектр
по вопросам Опель астра h номер краски узнать – обращайтесь в Telegram car71
My brother suggested I would possibly like this website.
He was once entirely right. This put up truly made my day.
You can not consider just how a lot time I had spent for this info!
Thank you!
Feel free to surf to my web blog – Begravelse Tølløse
Hi there friends, pleasant piece of writing and nice arguments commented
at this place, I am genuinely enjoying by these.
My blog post – holiday card
When some one searches for his vital thing, thus he/she wishes to be available that in detail, therefore that thing is maintained
over here.
I think that is among the such a lot significant information for me.
And i’m happy reading your article. But wanna commentary on some basic things, The web site taste is wonderful, the articles is
really nice : D. Excellent activity, cheers
LMCHING has established itself as an innovative leader in the shifting beauty
and health market, impressing consumers with its focus on versatility and groundbreaking
concepts.
In a period of heightened emphasis on customized solutions, LMCHING’s adaptive
attributes redefine excellence in the charm and wellness world.
LMCHING’s success is rooted in its core worths of inclusivity and adaptability.
By developing adaptive offerings, LMCHING highlights the value of satisfying individual differences.
Versatility for LMCHING is more than technology– it’s
a dedication to attending to individuals’ certain preferences and demands.
Via collaborations with popular names like authentic SkinCeuticals and Helena Rubinstein from LMCHING – Mavis, and HELENA RUBINSTEIN, LMCHING enhances its reach and resonance.
With a concentrate on superior high quality and progressive technology, both brands line up effortlessly with
LMCHING’s objectives.
They illustrate exactly how thoughtful partnerships enhance
consumer interaction and redefine opportunities within the charm sector.
Identified for its research-driven skin care, SkinCeuticals
provides unequaled proficiency and accuracy.
The brand’s outcome-oriented products reflect LMCHING’s dedication to adaptable and personalized options.
Whether resolving certain skin problems or shielding from outside aspects, SkinCeuticals adds
effectiveness and emphasis to LMCHING’s lineup.
HELENA RUBINSTEIN, a name steeped in high-end and innovation, enhances LMCHING’s
narrative by adding a touch of refinement and beauty.
HELENA RUBINSTEIN’s cutting-edge techniques and premium emphasis demonstrate
how flexibility boosts usefulness and luxury.
The cooperation reimagines the assimilation of high capability
with luxury.
LMCHING’s approach is led by its innovative application of sophisticated technology.
AI-enabled devices and dynamic formulas allow LMCHING’s products to respond flexibly to transforming user demands.
This method delivers products that excel in both functionality and responsiveness, redefining customization in skincare.
An instance is LMCHING’s skincare items, constructed to
adapt dynamically to individuals’ evolving concerns.
Addressing individual conditions strengthens consumer connections and transforms care routines into trips
of self-realization.
LMCHING’s dedication to green techniques is just as noteworthy.
Understanding the link in between appeal and ecological treatment, LMCHING incorporates lasting
techniques throughout its procedures.
Its use of ethically sourced materials and recyclable packaging shows how LMCHING mixes user-centric adaptability with worldwide
ecological objectives.
LMCHING’s comprehensive commitment to adaptability specifies every element of its
brand.
The brand name’s adaptability in both item and consumer relationships promotes loyalty amongst its customers.
Consumer responses reveals the life-altering impacts of LMCHING’s items,
showing its crucial role in personal care.
Partnerships with renowned names like SkinCeuticals and HELENA RUBINSTEIN emphasize LMCHING’s cutting-edge management.
Beyond business techniques, these alliances symbolize a common objective of enhancing customer experiences through
top-tier advancement.
Pooling their strengths, the collaborations establish a new standard for appeal and all natural care.
In recap, LMCHING’s dedication to unlocking capacity through adaptive features is reinventing the charm and wellness market.
With its focus on tailored solutions, eco-consciousness, and tactical collaborations, LMCHING
redefines consumer assumptions.
As LMCHING pushes boundaries, its impact will continue to drive progression in the beauty globe for several years ahead.
I visited multiple web pages except the audio quality for
audio songs current at this website is really excellent.
Hi to all, how is everything, I think every one is getting more from
this site, and your views are nice in favor of new visitors.
my homepage; Bedst bedømte bedemand i Holbæk åben nu
Hello! I just wanted to ask if you ever have any issues with
hackers? My last blog (wordpress) was hacked and
I ended up losing months of hard work due to no data backup.
Do you have any methods to prevent hackers?
Greetings from Los angeles! I’m bored to tears at work
so I decided to browse your blog on my iphone during lunch break.
I love the knowledge you provide here and can’t wait to take a look when I get home.
I’m shocked at how fast your blog loaded on my cell phone ..
I’m not even using WIFI, just 3G .. Anyhow, fantastic site!
My web site – Begravelsesforretning Slagelse
Fantastic blog you have here but I was wondering if you knew of any forums
that cover the same topics talked about in this article?
I’d really like to be a part of group where I can get suggestions from other experienced
people that share the same interest. If you have any suggestions, please let me know.
Cheers!
My website; Bedst bedømte bedemand i Sorø