tubo-ovarian adhesion release

Tubal ovarian adhesion lysis is very common in patients with tubal and ovarian adhesions in infertility and chronic pelvic pain. Mostly caused by infection, endometriosis and previous surgery. Usually the attachment will be fixed to the posterior or lateral wall of the broad ligament. The umbrella end of the fallopian tube is often wrapped. In severe cases, the attachment can be wrapped in the rectal fossa, which can easily damage the intestine during surgery. Treatment of diseases: complications of tubal malformation after tubal ligation Indication Infertility caused by fallopian tubes, ovarian adhesions, chronic pelvic pain, etc. Contraindications If fallopian tube hemorrhage occurs during surgery and if it is uncontrollable, fallopian tube resection should be performed immediately to avoid the excessive bleeding that threatens the patient's life. Preoperative preparation It should be 3-7 days after menstruation is clean. You can be admitted to the hospital 1 day after the menstruation is clean, because you need to prepare for 2-3 days before surgery, such as blood test type, ECG and so on. Surgical procedure First, see the relationship between the fallopian tubes, ovaries and surrounding organs, the nature, extent and extent of adhesions. Generally, the adhesion of the ovary is loosened first, and the fallopian tube can be released after the ovary is released. During operation, the non-invasive grasping forceps should be used to pull the two sides of the tissue to be separated to maintain a certain tension. For thin avascular adhesions, cut directly with scissors. The thick vascular adhesion zone should be cut off after bipolar coagulation. Another method of blocking the release is to use a water rinse separation method. This requires a dedicated flush pump. It separates the loose glue directly. For denser adhesions between different organs such as the intestine, ovary, etc., it can form a peeling surface or create a potential cavity in the adhesion to facilitate the next sharp separation and reduce damage. Adhesion of the ovary to the fallopian tube itself, especially the adhesion of the umbrella end of the fallopian tube, should be especially careful. Avoid damage to the ovarian surface and fallopian tube umbrella as much as possible. Otherwise, new adhesions will form after surgery. At this point, the lactated Ringer's solution can be injected into the uterine rectal fossa to float the ovarian fallopian tube, and the membranous adhesion of the ovarian surface and the fallopian tube umbrella is clearly seen. The clamp adhesive tape is cut off with a micro-scissor. There are many blood vessels in the adhesion zone here, so try not to use electrocoagulation or laser. A new adhesion is formed because it can cause thermal damage. After the operation is completed, 150-200 ml of lactated Ringer's solution or sodium hyaluronate can be placed in the pelvic cavity to prevent postoperative adhesion. complication The main complication is the possibility of having an ectopic pregnancy, so patients who are pregnant after surgery should check the B-ultrasound early to rule out the possibility of ectopic pregnancy.

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