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Silastic Band를 이용한 복강경 불임수술의 임상적 고찰 A Clinical Experience on Laparoscopic Sterilization with a Silastic Band

부산의대잡지 1977년 17권 2호 p.267 ~ 273
김현찬,
소속 상세정보
김현찬 (  ) 
부산대학교 의과대학 산부인과학교실

Abstract


In an attempt for clinical evaluation on laparoscopic sterilization with silastic bands, specially designed applicators have been used to apply a silastic band to the fallopian tube, thereby occluding it.
Three hundread and sixteen cases have been performed by several trainees under the supervision of author, from November 1, 1976 to the end of October, 1977. There have been no pregnancies. The technique is relatively easy but immediate postoperative pelvic pain is relatively high.
Complications such as transection and bleeding result when the tube is excessively thickened, when the tube is fixed in position by adhesion, or when tube is grasped too close to the cornu or too rapidly.
These complications have been relatively few and can be easily avoided and also managed easily by alternative method.
Analysis of clinical material shows the followings.
1. Age and the number of living children of clients are concentrated on 30-34 (36.7%); 35-39 (35.5%) and 3(51. 4%); 2(20. 9%), respectively.
2. Average number of pregnancy and artificial abortion are 6.8 and 3.4, respectively.
3. As to the educational level of the clients, it is concentrated on middle class level.
4. Contraceptive measures used prior to the sterilization procedure are IUD, pills, condom and rhythm in order. About 13.9% of clients used no contraceptives.
5. The selected cases of previous abdominal surgery are not complicated for the procedure, and minor surgical procedures such as D & C can be done concomitantly without any difficulty or increased complications.
6. The majority of cases (99. 1%) can be done under the local anesthesia without difficulty.
7. Consumed amount of CO: gas and time for the procedure are mainly depends upon the skill of the operator. The majority of cases can be done within 15 minutes with 2-3 liters of gas.
8. As to the subjective symptoms and objective signs, the followings are encountered in order; lower abdominal pain (14.6%), periumbilical pain (6.6%), shoulder pain(5.7%) and vaginal bleeding (3.2%) etc.
9. Complications are encountered in 18 out of 316 cases, being 7.2%. These are transection (2.5%), bleeding (1. 9%) and infection (0.9°0) in order.
The application of silastic band for tubal occlusion is simple once the technic and the instruments have been mastered. The advantage are enormous. The procedure is easier to teach and requires less complicated equipment than does electrosurgery. Only long-term assessment of the silastic band technic for its remote effect and value is now remained to be determined.

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