Satoskar Savni, Zhang Eva, Fan David, Teklu Yonas, Riera Gonzalez Cesar, George Teressa Sneha, Sikka Anshuman, Parikh Harsh R, Lois William
General Surgery, BronxCare Health System, Bronx, USA.
Surgery, St. George's University, St. George's, GRD.
Cureus. 2024 Jun 12;16(6):e62238. doi: 10.7759/cureus.62238. eCollection 2024 Jun.
A 36-year-old female presented to the gynecology office eight weeks after the placement of a ParaGard intrauterine device (IUD). Upon gynecologic examination, the strings of the IUD were not found. Magnetic resonance imaging was performed which reported the IUD embedded in the sigmoid colon. Initial diagnostic laparoscopy was done without bowel preparation and revealed an IUD embedded within the sigmoid colon and mesocolon. Colonoscopy did not reveal any breach of the colonic lumen. A second diagnostic laparoscopy was planned with the robotic-assisted technique after bowel preparation. Intraoperative findings during the second operation identified the IUD embedded in the antimesenteric side of the sigmoid colon with surrounding scar tissue to the uterus. The IUD was sharply freed using robotic scissors and the resulting serosal defect was sutured in layers with buttress made of appendices epiploica. The patient recovered well and had an excellent outcome. Our article highlights the minimally invasive method of dealing with a displaced IUD. The use of the robotic technique was helpful in our case to achieve an excellent outcome.
一名36岁女性在放置帕拉加德宫内节育器（IUD）八周后前往妇科就诊。妇科检查时，未发现IUD的尾丝。进行了磁共振成像检查，报告显示IUD嵌入乙状结肠。首次诊断性腹腔镜检查未进行肠道准备，结果发现IUD嵌入乙状结肠和结肠系膜内。结肠镜检查未发现结肠腔有任何破损。计划在肠道准备后采用机器人辅助技术进行第二次诊断性腹腔镜检查。第二次手术中的术中发现显示IUD嵌入乙状结肠的系膜对侧，周围有与子宫相连的瘢痕组织。使用机器人剪刀小心地将IUD取出，并用网膜制成的支撑物对 resulting 的浆膜缺损进行分层缝合。患者恢复良好，预后极佳。我们的文章强调了处理移位IUD的微创方法。在我们的病例中，使用机器人技术有助于取得极佳的效果。 （注：原文中“resulting”此处翻译存疑，可能原文有误，推测可能是“resultant”，但按要求未做修改）
