Each method of female sterilization has a failure rate of its own. Failure rates are higher if the procedure is carried out along with cesarean section, medical termination of pregnancy, or in early puerperium or postabortal state. That is so because the fallopian tubes are often edematous at such times, and the ligatures over them become loose when the edema goes away.
There are some methods which have a zero failure rate, such as Shirodkar’s method, Uchida’s method, and Oxford method. The success of these methods depends on separation of the cut ends of each fallopian tube from each other, so that recanalization cannot develop.
I have developed a new method for female sterilization in which the two ends are separated from each other using the utero-ovarian ligament and adjacent part of the broad ligament.
The steps of the procedure are as follows
The fallopian tube is divided between two hemostats in the isthmic portion, and each hemostat is replaced by a ligature of a nonabsorbable suture like linen or black silk. One thread of each ligature is kept long. The thread of ligature over the lateral cut end is threaded on a half circle round-body needle. The needle is then passed through the broad ligament just below the corresponding side utero-ovarian ligament, from behind forwards, so that it emerges close to the ligated medial cut end. The two threads are tied to each other. Thus the lateral portion of the fallopian tube passes over the uteroovarian ligament, and the lateral cut end lies on the posterior surface of the broad ligament, while the medial cut end lies on the anterior surface of the mesovarium under the ligament. Thus the two cut ends are separated by two layers of broad ligament below the utero-ovarian ligament, and cannot unite to cause recanalization.
The animation of the operation shown here is without the instruments like hemostats and needle holders. I did not include them because it would have taken me 2 weeks instead of the 2 hours I needed to do it. The interrupted red lines at the beginning show the cuts made in the fallopian tubes.
Monday, January 31, 2011
Female Sterilization: New Technique
Each method of female sterilization has a failure rate of its own. Failure rates are higher if the procedure is carried out along with cesarean section, medical termination of pregnancy, or in early puerperium or postabortal state. That is so because the fallopian tubes are often edematous at such times, and the ligatures over them become loose when the edema goes away.
There are some methods which have a zero failure rate, such as Shirodkar’s method, Uchida’s method, and Oxford method. The success of these methods depends on separation of the cut ends of each fallopian tube from each other, so that recanalization cannot develop.
I have developed a new method for female sterilization in which the two ends are separated from each other using the utero-ovarian ligament and adjacent part of the broad ligament.
The steps of the procedure are as follows
The fallopian tube is divided between two hemostats in the isthmic portion, and each hemostat is replaced by a ligature of a nonabsorbable suture like linen or black silk. One thread of each ligature is kept long. The thread of ligature over the lateral cut end is threaded on a half circle round-body needle. The needle is then passed through the broad ligament just below the corresponding side utero-ovarian ligament, from behind forwards, so that it emerges close to the ligated medial cut end. The two threads are tied to each other. Thus the lateral portion of the fallopian tube passes over the uteroovarian ligament, and the lateral cut end lies on the posterior surface of the broad ligament, while the medial cut end lies on the anterior surface of the mesovarium under the ligament. Thus the two cut ends are separated by two layers of broad ligament below the utero-ovarian ligament, and cannot unite to cause recanalization.
The animation of the operation shown here is without the instruments like hemostats and needle holders. I did not include them because it would have taken me 2 weeks instead of the 2 hours I needed to do it. The interrupted red lines at the beginning show the cuts made in the fallopian tubes.
