Thursday, April 30, 2015

POST PARTUM STERILIZATION


POSTPARTUM FEMALE STERILIZATION
Objective
Female sterilization within 3-7 days of normal delivery.
Position
Supine.
Anesthesia
Sedation + local anesthesia.
Procedure
1.  Empty bladder.
2.  Abdomen opened by 2-3 cm vertical incision below the level of palpable upper end of uterus.
3.  Retract abdominal wall to one side and push fundus of uterus to the opposite side.
4.  Visualize the Fallopian tube and hold with Babcock’s forceps to form 1-2 cm loop in its middle position.
5.  Pass no. 0 or no 1 chromic catgut through an avascular position of mesosalpinx.
6.  Ligate the base of loop on either side.
7.  Excise approx 1 cm of the loop.
8.  Repeat procedure on the opposite side.
9.  Close abdomen in layers.
Instruments
•   General set.
•   Doyen’s and self retaining retractor (Fig. 10.15).

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