Post Partum Tubal Ligation

 

Pre-operative diagnosis: *** y/o G*P*** presenting *** days postpartum who desires permanent sterilization.

Post-operative diagnosis: Same

Procedure: Postpartum tubal ligation, modified Pomeroy method

Surgeon: ***

Assistant: ***

Anesthesia: ***

Complications: None

EBL: <20 cc

IVF: ***

UOP: ***

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Findings:  normal postpartum uterus with fundus at umbilicus, normal tubes and ovaries visualized via infraumbilical incision

 

Specimens: portions of R and L fallopian tubes

 

Indication: *** yo G***P*** who desires permanent sterilization. She understands this procedure is not reversible and she would need to undergo in-vitro fertilization in the future. She was consented in accordance with state laws prior to her procedure. 

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Procedure: The patient was met in pre-operative holding and was re-consented as to the risks/benefits/indications of her procedure. She was then taken to the operating room where intermittent compression devices were placed and she underwent general anesthesia. A small transverse, infra umbilical skin incision was them made with the scalpel. The incision was carried down through the underlying fascia until the peritoneum was identified and entered. The peritoneum was noted to be free of any adhesions and the incision was then extended with Metzenbaum scissors.

 

The patient’s left Fallopian tube was identified, brought to the incision and grasped with a Babcock clamp. The tube was then followed out to the fimbria. The Babcock clamp was then used to grasp the tube approximately 4 cm from the cornual region. A 2-3 cm segment of the tube was then ligated with a free tie of plain gut x 2, and excised. Good hemostasis was noted and the tube was returned to the abdomen. A portion of the right Fallopian tube was then identified, ligated, and excised in a similar fashion. Excellent hemostasis was noted, and the right tube was returned to the abdomen.

 

The peritoneum and fascia were then closed in a single layer using 0 vicryl. The skin was closed in a subcuticular fashion.

 

The patient tolerated the procedure well and was taken to the recovery room in stable condition.

Sponge, instrument, and needle count were correct times 3.