Ozen Ibrahim Onur, Bagbanci Baris, Demirtola Arzu, Karabulut Ramazan, Ozen Ozlem, Demirogullari Billur, Turkyilmaz Zafer, Sonmez Kaan, Basaklar Abdullah Can, Kale Nuri
Faculty of Medicine, Department of Pediatric Surgery, Gazi University, Ankara, Turkey.
Pediatr Surg Int. 2006 Oct;22(10):815-9. doi: 10.1007/s00383-006-1734-4. Epub 2006 Aug 11.
The purpose of this study is to describe a technique, that is as successful as microsurgery in terms of patency rates and histopathologic assessments, and can be performed even by untrained hands in microsurgery, for repairing vas deferens injuries that can be perceived during inguinal herniorrhaphy. Thirty male Wistar-Albino rats were randomly allocated to five groups. In control group, the vas deferens was harvested without any surgical intervention (Group 1) and in sham group the vas was harvested after a limited dissection (Group 2). Three suture approximation technique was carried out in Group 3, and a novel vasovasostomy technique was carried out by using a hypodermal needle in Groups 4 and 5, with polypropylene and polyglactin 910 (rapid vicryl), respectively. Results were evaluated in terms of operative time, patency and flow rates, inflammation and sperm granuloma. The mean operative times for hypodermal needle assisted approximation of Groups 4 and 5 were found significantly less than Group 3. The compared results of the groups in terms of patency, flow rate, inflammation and spermatic granuloma indicated Group 4 to be superior to the other groups. We have found the hypodermal needle assisted approximation technique to be easier, less time consuming and cost effective. With these promising results, this modus operandi can be described as an appropriate technique for vas deferens transection repairs.
本研究的目的是描述一种技术，该技术在通畅率和组织病理学评估方面与显微外科手术一样成功，即使是未经显微外科培训的人员也可操作，用于修复腹股沟疝修补术中可能出现的输精管损伤。将30只雄性Wistar - 白化病大鼠随机分为五组。对照组在无任何手术干预的情况下摘取输精管（第1组），假手术组在有限解剖后摘取输精管（第2组）。第3组采用三重缝合近似技术，第4组和第5组分别使用聚丙烯和聚乙醇酸910（快薇乔）通过皮下注射针进行一种新型输精管吻合技术。从手术时间、通畅率和流速、炎症和精子肉芽肿方面评估结果。发现第4组和第5组皮下注射针辅助近似技术的平均手术时间明显短于第3组。在通畅率、流速、炎症和精子肉芽肿方面各小组的比较结果表明第4组优于其他组。我们发现皮下注射针辅助近似技术更简便、耗时更少且具有成本效益。鉴于这些令人满意的结果，这种手术方式可被描述为一种适用于输精管横断修复的技术。
