目的探讨腹腔镜下大子宫全切术的可行性、安全性以及临床效果。方法郑州市妇幼保健院妇科对86例子宫大小在12～18孕周的子宫良性疾病患者施行改良腹腔镜下全子宫切除术的临床资料,分析手术时间、术中出血量、手术并发症、术后排气时间、术后病率情况。结果 86例全部在腹腔镜下完成手术,无1例中转开腹;术中无输尿管、膀胱、肠管损伤,无因术中出血而输血的病例,皮下气肿4例,皮下血肿1例,穿刺孔感染1例,残端感染2例(经残端拆线引流及抗生素应用痊愈);术后病率为4.65%。86例全部随访3个月,妇科检查阴道残端均愈合好,光滑,无肉芽增生。无尿漏、粪漏等严重并发症发生。结论术前认真评估,术中综合运用上移穿刺孔、选择30°腹腔镜、改变手术步骤(腹腔镜下先阻断子宫动脉、后原位缩减子宫体积、再切除子宫)及LH专用举宫器的使用,大子宫全切除术仍是安全、可行的,不会增加手术危险性和手术并发症。 Objective To investigate the feasibility, safety and clinical effect of laparoscopic hysterectomy. Methods Maternal and Child Health Hospital of Zhengzhou City, 86 cases of uterine size between 12 to 18 gestational weeks in patients with benign uterine disease underwent modified laparoscopic hysterectomy clinical data analysis of operative time, intraoperative bleeding, complications, surgery After the exhaust time, postoperative morbidity. Results All of the 86 cases underwent laparoscopic surgery and none of them underwent laparotomy. No ureter, bladder or bowel injury were found in the operation, and no transfusion was found due to intraoperative bleeding. There were 4 cases of subcutaneous emphysema, 1 case of subcutaneous hematoma, Infection in 1 case and stump infection in 2 cases (cured by stump removal and antibiotic application). Postoperative morbidity was 4.65%. 86 cases were followed up for 3 months, gynecological examination of vaginal stump healed well, smooth, no granulation hyperplasia. No urine leakage, leakage and other serious complications occurred. Conclusions The preoperative assessment was rigorous. The intraoperative comprehensive application of puncturing the laparotomy led to the selection of 30 ° laparoscopy, surgical procedures (laparoscopic first block of uterine artery, reduction of uterine volume in situ, resection of the uterus) The use of large hysterectomy is still safe and feasible, will not increase the risk of surgery and surgical complications.