宫内节育器取出术，简称取环术。全球约18%女性放置宫内节育器，过去为了响应国家计划生育政策，许多育龄女性放置宫内节育器。由于缺少宣传及科普，部分女性放置20年以上不曾更换，绝经后害怕疼痛不敢取出，直到出现腹痛、腰痛、阴道流血、流液才到医院就诊。但由于绝经宫颈封闭萎缩、节育环嵌顿，如何安全取出节育器，减少创伤，成为困扰临床医师的一大难题。2022年《阴道内镜技术中国专家推荐意见》^[1,2]，2025年《无能量宫腔镜技术临床应用中国专家推荐意见》^[3]发布，使阴道内镜技术更规范地应用于临床，结合无能量宫腔镜器械，为绝经后取环提供完美解决方案。使用外径<5 mm的镜头，减少对宫颈的扩张、疼痛刺激，可实现无麻醉阴道内镜取环。使用5 Fr剪刀分离嵌顿节育环，结合旁入式取出技巧，有利于降低器械损坏、提高取环效率，减少住院，值得临床推广应用。

Intrauterine device(IUD) removal, a gynecological procedure, is widely performed. Globally, approximately 18% of females use IUDs for contraception. In the past, many women had IUDs inserted to comply with national family planning policies. However, some women, due to fear of pain and lack of awareness, have not had their IUDs replaced for over 20 years and only seek medical attention when experiencing symptoms such as abdominal pain, back pain, vaginal bleeding, or discharge after menopause. Postmenopausal changes like cervical atrophy and IUD embedment pose challenges for safe and less traumatic removal. In 2022 and 2025, the publication of the Chinese Expert Consensus on Vaginoscopy provided standardized guidance for clinical application of vaginoscopy and Clinical recommendations from Chinese experts on no energy hysteroscopic techniques, offering an effective solution for postmenopausal IUD removal combine with no energy. Using the scope with an outer diameter of less than 5 mm reduces cervical dilation and pain, enabling removal without anesthesia. The use of 5 Fr scissors to separate embedded IUDs and a lateral removal approach decrease the risk of instrument damage, enhance removal efficiency, and reduce hospitalization. This method is recommended for broader clinical application.