LAPAROSCOPIC FEMALE STERILIZATION
Objective
Same as for mini laparotomy female sterilization.
Position
Lithotomy + Trendelenburg < 150.
Anesthesia
• Sedation + Local anesthesia.
• General anesthesia (if patient is uncooperative).
Procedure
1. Empty bladder.
2. Introduce Sims’ speculum and visualize cervix.
3. Insert uterine elevator in proper direction to allow manipulation of the uterine and withdraw speculum.
4. Make a small abdominal opening just below umbilicus and insert. Verees needle in the peritoneal cavity.
5. Infuse 1-2 l of CO2 into the cavity at the rate of 3/4 l/mm.
6. Increase the infraumbilical incision and introduce trocar 45° toward the pelvis.
7. Withdraw obturator and introduce assembled laparoscope into the abdominal cavity.
8. Identify and group the ovi duct by tongs and drain into sleeve of the laparoscope.
9. Push the falope ring over the knuckle of the tube 3 cm from the cervical area.
10. Repeat procedure on the other side.
11. Withdraw laparoscope and expel CO2 from the abdominal cavity.
12. Close the incision.
Instruments
• General set.
• Verees needle 1 (Fig. 10.36).
• Light source with bulb for laparoscope 1.
• Fiberoptic cable 1.
• Trocar with cannula 1.
• Operating laparoscope 1.
• CO2 gas cylinder 1.
• Pneumoperitoneum insufflation apparatus 1.
• Falley’s rings 2.
Any questions be sent to drmmkapur@gmail.com
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