改良单针法纵向套叠显微输精管附睾吻合术 (“大家泌尿网”观看手术视频)

A newly modified single-armed suture longitudinal intussusception technical advancement of microsurgical vasoepididymostomy

梗阻性无精子症(OA)是男性不育的重要原因之一,而附睾梗阻是梗阻性无精子症中最常见的病因。因此,如何安全、有效地解除附睾梗阻对治疗男性不育有十分重要的意义。随着显微技术的迅速发展,显微输精管附睾吻合术(MVE)已成为附睾梗阻最主要的治疗方式之一。大量数据表明MVE是现今治疗附睾梗阻最好、最安全有效的选择之一。通过数十年的发展,目前MVE的术式也越来越丰富,主要包括双针法横向套叠、双针法纵向套叠、单针法横向套叠以及单针法纵向套叠的MVE,而本团队对单针纵向套叠法MVE进行了改良技术升级,缩短了手术时间,解决了某些地区和国家无特制男性不育显微双针10-0缝线的问题,使之适合更多的医师进行学习和安全操作、适合更多的医院开展MVE。本文将对改良单针法纵向套叠MVE的手术步骤及操作要点等方面进行论述。

Obstructive azoospermia(OA)caused by epididymal obstruction is one of the most essential etiologies of male infertility,in which relieving epididymal obstruction is of great significance.With the rapid development of microsurgical techniques,longitudinal intussusception microsurgical vasoepididymostomy(MVE)has become one of the most recognizable microsurgical approaches in the treatment of epididymal obstruction.Many compelling data indicate that MVE has become the op-timal,cost-effective choice for the treatment of epididymal obstruction.After decades of development,various MVE with end-to-end techniques are becoming applicable worldwide,including the double-armed transverse suture intussusception,double-armed suture longitudinal intussusception,single-armed transverse suture intussusception,and single-armed suture longitudinal intussusception.We recently modified the micro-suture placement using a single-armed needle MVE technique to solve the real marketing issues of the lack of specialized double-armed micro-suture in many developing countries,making it more maneuverable without sacrificing the surgical outcomes and safety.This article describes and emphasizes the key points of performing the modified single-armed suture longitudinal intussusception of microsurgical vasoepididymostomy.