| 摘要 |
A system and method are disclosed for removing a uterus using a fluid enclosure inserted in the peritoneal cavity of a patient so as to enclose the uterus. The fluid enclosure includes a distal open end surrounded by an adjustable loop, that can be tightened, a first proximal opening for inserting an electrosurgical instrument into the fluid enclosure, and a second proximal opening for inserting an endoscope. The loop is either a resilient band extending around the edge of the distal open end or a drawstring type of arrangement that can be tightened and released. The fluid enclosure is partially inserted into the peritoneal cavity of a patient in a deflated condition and then manipulated within the peritoneal cavity over the body and fundus of the uterus to the level of the uterocervical junction. The loop is tightened around the uterocervical junction, after which the enclosure is inflated using a conductive fluid. The loop forms a pressure seal against the uterocervical junction to contain the conductive fluid used to fill the fluid enclosure. Endoscopically inserted into the fluid enclosure is an electrosurgical instrument that is manipulated to vaporize and morcellate the fundus and body of the uterus. The fundus and body tissue that is vaporized and morcellated is then removed from the fluid enclosure through the shaft of the instrument, which includes a hollow interior that is connected to a suction pump The fundus and body are removed after the uterus has been disconnected from the tissue surrounding uterus.
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