Hadj-Moussa Miriam, Brown James A
Division of Urology, Medical College of Georgia, Augusta, Georgia, USA.
Can J Urol. 2010 Jun;17(3):5213-5.
We describe a technique of surgical clip placement, which prevents slippage when ligating the folded vas deferens during vasectomy.
We utilized this technique in 25 consecutive vasectomy procedures. After isolating the vas, two mosquito clamps are placed approximately 2 cm-3 cm apart and a small 5 mm-10 mm section of full thickness vas is removed. The lumen of each cut end is cauterized. Surgical clips (Ethicon Ligaclip Extra LS-200, Medium) are placed at approximately 2 mm, 3 mm and 15 mm (on the opposite side of the hemostat) from each cut end. By rotating the hemostat, the vas is folded on itself and a 3-0 or 4-0 chromic suture is placed between the two proximal clips and distal to the third clip. The hemostat is carefully removed and the vas gently ligated.
A single surgeon noted no instances of suture slippage in 25 consecutive vasectomies. All patients underwent postoperative semen analysis that showed azoospermia.
Placement of the ligating suture between two proximal clips and past a third distal clip prevents suture slippage when ligating the folded end of the vas deferens during vasectomy.
我们描述一种手术夹放置技术，该技术可防止在输精管结扎术中结扎折叠的输精管时发生滑脱。
我们在连续25例输精管结扎手术中采用了该技术。分离输精管后，放置两把蚊式夹，相距约2厘米至3厘米，切除一小段5毫米至10毫米全层输精管。烧灼每个断端的管腔。手术夹（爱惜康结扎夹Extra LS - 200，中型）分别放置在距每个断端约2毫米、3毫米和15毫米（在止血钳的对侧）处。通过旋转止血钳，使输精管自身折叠，在两个近端夹之间且在第三个夹的远端放置一根3 - 0或4 - 0铬制缝线。小心移除止血钳并轻轻结扎输精管。
一位外科医生在连续25例输精管结扎术中未发现缝线滑脱的情况。所有患者术后精液分析均显示无精子症。
在输精管结扎术中，在两个近端夹之间且越过第三个远端夹放置结扎缝线可防止结扎折叠的输精管末端时缝线滑脱。
