电视腹腔镜下手术治疗输卵管银夹绝育术后银夹移位

Video laparoscopic operational treatment of silver clips displacement after fallopian tube sterilization by silver clips

目的:探讨电视腹腔镜下手术治疗输卵管银夹绝育术后银夹移位的临床价值。方法,回顾性分析我院2001年1月～2004年1月用电视腹腔镜下手术治疗输卵管银夹绝育术后银夹移位23例的临床资料。结果:手术证实23例均为输卵管峡部结扎,共26个银夹脱落移位,其中,左侧移位15个(占57.7%),右侧移位5个(占19.2%),左右侧均移位6个(占23.1%)。镜下一次性取出异位银夹25个,1个异位银夹因取出困难未能取出,本组成功率为96.2%(25/26)。手术同时发现部分病例合并其他病理情况,其中,盆腔粘连6例,盆腔静脉淤血症1例,输卵管积水1例,卵巢巧克力囊肿1例,均逐一进行镜下相应处理。全部病例术中术后未出现任何并发症。结论:电视腹腔镜下手术取出移位银夹方法简便,组织损伤小,能同时治疗合并的其它病变,手术成功率高,是一种首选的治疗银夹移位的方法,值得临床上推广应用。

Objective ： To discuss clinical values of video laparoscopic operational treatment of silver clips displacement after fallopian tube sterilization by silver clips. Methods： The clinical data of 23 patients under laparoscopy for silver clips displacement between Jan. 2001 and Jan. 2004 were analysed retrospectively. Results： Laparoscopy revealed that methods of the fallopian tube sterilization were all tube isthmus ligation for 23 patients, altogether 26 silver clips displacement, including left 15 silver clips displacement （57. 7% ）, right 5 （192%） and both 6 （23. 1% ）. Laparoscopic approach extracted successfully 25 clips, 1 clip fail to extract for handling difficulty, success rates were 96. 2% （25/26）. On the other hand, laparoscopy also finded coexisting other diseases, including 6 cases of pelvic adhesion, 1 case of pelvic venous congestion sign, 1 case of fallopian hydrocele and 1 case of ovarian chocolate cyst, the whole coexisting diseases were managed by laparoscopic approach at the same time according to each etiology. All patients did not suffer any complications interoperation and afteroperation. Conclusion： Video laparoscopic operational extraction of silver clips displacement has characteristics of simply method, small tissue injury therapy coexisting other diseases at the same time and high operational success rates, being primarily treatment method of silver clips displacement after fallopian tube sterilization by silver clips, deserving widespread clinical application for the future.