Singh Kamalpreet, Mitra Binay, Singh Kanwarjit, Kumar Mishra Awadhesh, Singhal Ravi
Classified Specialist (ENT), 166 Military Hospital, C/o 56 APO, India.
Senior Advisor (Obst & Gynae), 166 Military Hospital, C/o 56 APO, India.
Med J Armed Forces India. 2021 Jul;77(Suppl 2):S499-S501. doi: 10.1016/j.mjafi.2020.10.016. Epub 2021 Feb 23.
The breaking of the tip of the 'Karman cannula' inside the uterine cavity while performing suction curettage for missed abortion is an extremely rare phenomenon. Ideally, such foreign bodies should be removed using a hysteroscope under direct vision. In the absence of a hysteroscope, retrieval may be attempted using retrieving forceps either under ultrasonographic guidance or blindly. A 26-year-old female patient presented as a case of missed abortion at 6 weeks of gestation and underwent suction and evacuation. The tip of the cannula broke during the procedure. Multiple attempts were made to retrieve the cannula tip using forceps under ultrasound guidance without success. The patient was planned to be shifted to a higher centre as the hysteroscope was not available at this centre. However, owing to travel restrictions and lockdown imposed for the coronavirus disease 2019 (COVID 2019) pandemic, the patient could not be transferred. An innovative method using the fibre optic bronchoscope was devised by the otorhinolaryngologist and gynaecologist, and the retained impacted cannula was safely removed from the left uterine cornu under vision.
在对稽留流产进行吸刮术时,“卡门套管”尖端在子宫腔内折断是一种极为罕见的现象。理想情况下,此类异物应在直视下通过宫腔镜取出。若没有宫腔镜,可尝试在超声引导下或盲目使用 retrieval 钳取出。一名 26 岁女性患者因稽留流产在妊娠 6 周时就诊并接受了吸宫术。手术过程中套管尖端折断。在超声引导下多次尝试用钳子取出套管尖端但未成功。由于该中心没有宫腔镜,计划将患者转至上级中心。然而,由于 2019 冠状病毒病(COVID - 2019)大流行实施的旅行限制和封锁,患者无法转移。耳鼻喉科医生和妇科医生设计了一种使用纤维支气管镜的创新方法,在直视下将残留的嵌顿套管从子宫左角安全取出。