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1、TVT-O治疗女性压力性尿失禁*TrademarkGYNECARETVT*Tension-freeSupportforIncontinenceTVT尿失禁无张力支持TVT的尿道中段悬吊已经成为“金标准”Long-term,sevenyearfollow-updatapresentedat2003IUGAreported+Curerateof81%Significantlyimprovedrateof16%Comparableto5yeardataof85%/11%respectivelyVerylowratesofreportedm
2、ajorcomplicationsinover500,000patientsReportedbowelinjurylessthan6/100,000proceduresReportedmajorvascularinjurylessthan9/100,000procedures+Nilsson,et.al,7YearFollow-upoftheTension-freeVaginalTape(TVT)Procedure;InternationalUrogynecologyJournal,IUGAAbstract#116(89);Octo
3、ber,2003.ComplicationsStatementComplicationUSEx-USTotal%血管损伤737440.009尿道磨损200200.004肠损伤1612280.006神经损伤3140.0008血肿416200.004MostSignificantReportedComplications++Basedonover500,000patientstreatedworldwide++AsofSeptember26,2003,sevendeathsareassociatedwithGYNECARETVT.Six
4、caseswereforbowelperforation.Fivewereassociatedwithundiagnosedbowelperforationsatthetimeofsurgery.Inthesixthcaseofbowelperforation,noadditionalinformationcouldbeobtained.Theseventhcasewasassociatedwithawomanwhohadableedingdisorderwhodiedfromuncontrolledpostoperativeble
5、edingintheretropubicspace.ConceptDevelopmentofGYNECARETVTObturatorProfessorJeandeLeval,ChairmanofUrologyattheUniversityofLiege,Belgium为什么经闭孔?避开耻骨后空间可能带来的好处减少膀胱穿孔，尤其对有手术史的病人避免耻骨后血肿避免肠穿孔减少大血管的损伤悬吊带方向的改变可能带来的好处减少术后尿潴留的发生率手术时间更短RetropubicSlings(“U”shaped)F1F1F2F2ObturatorS
6、lings(HammockShaped)“U”Shapevs.HammockShapeHammockshapeofslingmayresultinlessobstructivesymptomsand/ordenovourgency,sinceitishardertoovercompresstheurethra悬吊带方向的改变减少梗阻的发生和术后急迫症状However,thismayalsomakeitmoredifficulttocorrectcertainpatients,suchasthosewithISD但是，对于ISD的病人
7、可能不能完全纠治GYNECARETVTObturatorSystemConsistsofthreemajorcomponentsGYNECARETVT经闭孔吊带GYNECARETVT螺旋穿刺针GYNECARETVT蝶型导引器BlisterpackageShownwithTyvekLidremovedGYNECARETVTObturatorSystem吊带锥形头的塑料管连于带塑料外套的蓝色普理灵网带塑料管和组件的材料-聚乙烯-聚亚安酯塑料管直径4.2-4.8毫米(从尖锥部到底部)螺旋穿刺针预先放置于塑料套内固定在塑料套内材料聚碳酸酯的
8、手柄-不锈钢穿刺针BendableTabs6cm7cmGYNECARETVTObturatorSystem蝶型导引器有助于螺旋穿刺针准确一致地穿过组织6公分长,可以延长至7公分.WorkstationDesignWithlefthan
