腹腔内に迷入した子宮内避妊具を3D内視鏡システム併用単孔式腹腔鏡手術で摘出した一例

抄録

　Intrauterine devices (IUDs) are useful for contraception, but in rare cases perforate uterus and migrate into the abdominal cavity. We report a case of ectopic IUD removal by single-incision laparoscopic surgery (SILS). The patient was a 46-year-old woman, gravida 2, para 2, who had an IUD inserted for contraception four years previously. She visited for a replacement IUD but the doctor could not find her original IUD in the uterus by ultrasound. Abdominal X-ray revealed that the IUD had migrated into the abdominal cavity. She was referred to our hospital to remove the ectopic IUD. Pelvic 3D-CT determined the position of the IUD in the pelvic cavity. After confirming the position of the IUD using a surgical C-arm-type X-ray fluoroscope in the operating room, we observed the abdominal cavity by 3D flexible laparoscope and found the IUD adhered to right ovary. We smoothly removed the migrated IUD by SILS. The patient was discharged from the hospital on the third postoperative day without any notable complications. In conclusion, SILS could be an effective option for IUD removal in appropriately selected cases with devised preoperative evaluation.