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02 May 2023, Volume 39 Issue 5 Previous Issue    Next Issue

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Abdominal hysterectomy：essential skills and required course for obstetricians and gynecologists. ZHANG Shi-qian 2023, 39(5): 485-489.  DOI: 10.19538/j.fk2023050102 Abstract ( )   With the development of hysterectomy，debates on advantages and disadvantages of abdominal hysterectomy and other surgical approaches have subsided. We discussed the history of abdominal hysterectomy，the advantages and disadvantages，the difficulties and key points in exceptional circumstances，and the rational choices. Safety，cost-effectiveness，and efficiency must be the core principles for any choice. In a way，abdominal hysterectomy is still a required course for obstetricians and gynaecologists.

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Transvaginal hysterectomy：re-evaluation and key points of operation. ZHOU Ning 2023, 39(5): 489-493.  DOI: 10.19538/j.fk2023050103 Abstract ( )   Hysterectomy is the most basic and common operation for the treatment of gynecological benign diseases，among which vaginal hysterectomy is the earliest operation，and the best path of hysterectomy has been widely discussed. This paper briefly describes the historical development of vaginal hysterectomy，summarizes the advantages and re-evaluation and surgical indications and expansion of vaginal hysterectomy，and the key points of specific surgical techniques in order to better master the technique，and analyzes and discusses the common complications of vaginal hysterectomy and the prevention and treatment measures. Vaginal hysterectomy has its safety and feasibility in the treatment of gynecological benign diseases. However，more training is needed in the basic training of specific surgical techniques of vaginal surgery so that more gynecologists can master this minimally invasive technique.

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Laparoscopic hysterectomy for benign gynecological diseases：advantages and disadvantages.  LI Fang-mei, ZHANG Yi 2023, 39(5): 493-498.  DOI: 10.19538/j.fk2023050104 Abstract ( )   Laparoscopic hysterectomy is a common surgical procedure for gynecological benign diseases. With the increasing maturity of laparoscopic technology，its indications continue to expand. In clinical practice，it is necessary to strictly master surgical indications，perform preoperative accurate evaluation and discussion，strengthen laparoscopic training and improve technical level，be familiar with the use of energy instruments，master laparoscopic surgical skills，and standardize postoperative monitoring，so as to maximize the advantages of laparoscopic technology in gynecological benign diseases.

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Robot hysterectomy for gynecological benign diseases：will it replace surgeons？ TONG Jun-ru, FAN Jiang-tao 2023, 39(5): 498-503.  DOI: 10.19538/j.fk2023050105 Abstract ( )   Hysterectomy is the main method to treat benign gynecological diseases，and has become one of the most basic and common gynecological operations. With the development of science and technology，robot surgery system，as a new trend of minimally invasive surgery，has been gradually applied to various gynecological operations. This paper briefly describes the historical development of robot surgery system，summarizes the surgical indications of robot hysterectomy，studies the advantages and disadvantages of robot compared with traditional minimally invasive surgery and its application in special populations，and analyzes and discusses the learning curve，complications and the prevention measures. Compared with traditional minimally invasive surgery，the robot surgery system has its safety and feasibility in total hysterectomy for gynecological benign diseases.

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Hysterectomy by transvaginal natural orifice transluminal endoscopic surgery：a preliminary study on “third generation surgery”. ZHONG Kui-yan, WANG Yan-zhou 2023, 39(5): 504-507.  DOI: 10.19538/j.fk2023050106 Abstract ( )   Total hysterectomy is a common surgical procedure for the treatment of gynecological benign uterine lesions.vNOTES Surgery is known as the "third generation of surgery" after open surgery and traditional laparoscopic surgery，which is gradually applied in gynecological surgery.By reviewing the relevant domestic and foreign literature and clinical practice experience，the current status，advantages and limitations of vNOTES total hysterectomy are comprehensively and systematically expounded.The learning curve，complications and prevention measures of vNOTES total hysterectomy are analyzed and explored.

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Advantages and disadvantages of transumbilical laparo-endoscopic single-site（LESS）hysterectomy for benign disease. WANG Yong-jun 2023, 39(5): 508-511.  DOI: 10.19538/j.fk2023050107 Abstract ( )   The transumbilical laparo-endoscopic single-site（LESS）hysterectomy  was applied at the same time as the multi-port laparoscopy in 20th century. But due to many limiting factors of endoscopic technology and single small incision surgical access，the progress of this technology develop more slowly than the multi-port laparoscopy hysterectomy. Because of the obvious advantages of multi-port laparoscopic hysterectomy，total hysterectomy is mainly completed by the multi-port laparoscopy. In the recent decade，with the optimaization of surgical instruments for laparo-endoscopic single-site and surgical experiences accumulation，the transumbilical laparo-endoscopic single-site（LESS） hysterectomy has been reborn in the "crevice" of multi-port laparoscopy，and its advantages are gradually emerging. It is not only comparable to multi-port laparoscopic hysterectomy，but also highly favoured by gynaecologists and patients. So this article mainly focuses on the related issues of surgery characteristics，indications，and advantages and disadvantages of the LESS hysterectomy.

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Effect of different surgical methods and routes of hysterectomy on ovarian function. LIU Hong-hui, ZENG Xiao-qin, SUN Ai-jun 2023, 39(5): 512-516.  DOI: 10.19538/j.fk2023050108 Abstract ( )   In this paper，the authors searched the literature on the influence of hysterectomy on ovarian function and sorted out the relevant viewpoints. Studies suggest that hysterectomy has an impact on ovarian function，but generally，ovarian function declines 2-3 years after surgery，resulting in earlier menopause. In the study of different surgical methods，compared with subtotal hysterectomy，total hysterectomy has a more significant impact，and the removal of bilateral fallopian tubes at the same time of hysterectomy has a greater impact. Different surgical routes mainly include transabdominal hysterectomy，vaginal hysterectomy and laparoscopic hysterectomy. The vaginal route has the greatest impact and the laparoscopic route has the least impact. Ovarian function is an important factor to maintain women's health，hysterectomy leads to the decline of ovarian function，and the menopause is 2-3 years ahead of schedule. Therefore，it is recommended to strictly grasp the indications of hysterectomy in clinical work to avoid the decline of ovarian function endangering women's health.

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Advantages and disadvantages of different pathways to hysterectomy based on changes in sexual psychology. HE Si-yi, ZHANG Guo-nan 2023, 39(5): 516-520.  DOI: 10.19538/j.fk2023050109 Abstract ( )   Hysterectomy is one of the most common gynecological surgeries. Since the first case of hysterectomy，in addition to the traditional transabdominal hysterectomy （AH），the surgical pathway has become more abundant.For patients with different needs，choosing the best pathway can not only reduce the pain caused by the disease，but also minimize the impact of surgery，promote the recovery of patients，and reduce postoperative complications. With the liberalization of ideas and concepts，people's demand for a pleasant sexual life gradually increases，and the impact of the surgical pathway on postoperative sexual function has become the cause of anxiety before surgery for many women. This article analyzes the effects of different hysterectomy pathways on patients' postoperative sexual health from the perspective of sexual psychology.

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Effect of different routes of hysterectomy on female pelvic floor urinary function.  LIU Ping, XU Li-qun 2023, 39(5): 520-524.  DOI: 10.19538/j.fk2023050110 Abstract ( )   Hysterectomy is one of the causes of female pelvic floor dysfunctional diseases. Different routes of hysterectomy have different effects on pelvic floor urinary function. This article summarizes the differences in the effects of three different routes of hysterectomy on female pelvic floor and the measures to prevent postoperative pelvic floor dysfunctional diseases，providing ideas for clinicians to choose the routes of hysterectomy.