输卵管显微手术的七项基本原则

Seven Fundamental Principles of Tubal Microsurgery

输卵管疾病是女性不孕的重要原因之一,包括输卵管近端阻塞,远端粘连、闭锁、积水,输卵管妊娠和绝育术等。输卵管显微手术和体外受精-胚胎移植(IVF-ET)技术是目前主要的治疗方法,两者互为补充。为了在风险最小的情况下提高妊娠率,输卵管显微手术应该由腹腔镜等微创手术经验丰富的医生来完成,并遵循7项基本原则:1一定要有手术适应证;2恰当的患者选择;3选择创伤最小的方法;4具备显微外科器械;5组织损伤最小化;6精确的解剖重建;7避免手术并发症。优秀的外科医生更加注重手术操作细节,懂得如何取舍,并且选择正确的术式实现患者利益最大化。

Fallopian tube disease is an important factor of female infertility, including proximal tubal obstruction, distal tubal occlusion, hydrosalpinx, peritubal adhesions, tubal pregnancy and sterilization. Reproductive microsurgery and in-vitro fertilization and embryo transfer （IVF-ET） technology are two treatment modalities, being complementary to each other. Tubal microsurgery should be performed by experienced surgeons in microsurgery and laparoscopy. There are seven fundamental principles of tubal microsurgery as follows： ①to ensure appropriate indications; ②to select correct patients; ③to adopt the least invasive approach; ④to use microsurgery instruments; ⑤to minimize tissue damage; ⑥to ensure precise anatomy reconstruction; ⑦to reduce complication. In this way, the benefit of tubal surgery will be maximized by cautious operation and perfect procedure.