복강경불임술에 관한 임상적관찰 = Clinical Study on Laparocopic Sterilization

다국어 초록 (Multilingual Abstract)

Recently the use of laparoscope for diagnostic and therapeutic measures in gynecology has become increasingly popular, and great enthusiasm has been generated for female aterilizations using laparoscopy. From June 1974 to April 1977, 3030 cases of laparoscopic tubal sterilization were performed by means of fulguration and silastic ring apply under mostly local anesthetics. Three thouend and thirty cases were analysed and the following results were obtained. 1. The age distribution showed 41.3% from age 30 to 34, and over 90% of patients are aged between 25 and 39 years old. 2. Majority of patients (47.7)have two children and average number of child was 28 in over all group. 3. Sterilization procedure was performed during follicular phase in 53%, Ovulatory phase in 10%, and luteal phase in 37%. Duration between last induced abortion and sterilization, was 1 to 6 month period and 60.7% of the patients had sterilization in more than 3 years from the time of last delivery. 4. Most of the patients (36.3%) have had history of 2 or 3 times induced abortion. Also, educational background were elementary, middle and high school in order of frequency. 5. In 52.7% of the patients, sterilization was recommended by the public health nurses, 23.7% from private clinics and 22.2% from patient herself. 6. The contraceptive methods prior to sterilization were 30.9%(978 cases)with oral contraceptives, 26.5%(844cases) by the IUCD and none of method were used in 17.7% (561cases). 7. The 170cases(5.6%) had previous laparotomy, and 78cases of among those cases had appendectomy as most. 8. Steriliazation procedure have been done under local anesthesia in 99.6%, and under general anesthesia in 0.4% (13 cases). 9. One to two liters of CO2 gas consumed for pneumoperitoneum in 62%, and it tooks less than 10 minutes to complete laparoscopic tubal sterilization in 10.1% of all cases. 10. Most beloved technique in electric coagulation method in 84.2%, and incidental pregnancy termination at the first trimester was performed in 245 cases by Menstrual Regulation or D&E. 11. Incidental findings of uterus during laparoscopic sterilization were seen in 19 cases (6.0%) if subserosal myoma and few cases of adhesions, fifty cases (34.3%) were shown the evidence of salpingitis, and various size of ovarian cyst were found to be in 44 cases (56.4%) 12. Postoperative subjective complaints were seen in 660 patients (26.1%) with most common symptoms of shoulder pain and lower abdominal discomfort. 13. There were two serious complications requiring laparotomy among all complication of 67 cases (2.2%), mostly complicated from controlable bleeding from mesosalpinx. And operative failure was 3 cases of ectipic pregnancy and 2 cases of intrauterine pregnancy.