Female sterilization procedure

There are many methods of contraception. Many women who have given birth will choose to have a sterilization operation to prevent pregnancy. Sterilization is a relatively common contraceptive method in modern times. The contraceptive effect is better after sterilization. Many people still don’t understand how sterilization is performed, don’t understand what the surgical process is like, and worry about the consequences of sterilization. What is the process of female sterilization surgery like? Let’s take a look at it next.

1. What is the procedure for female sterilization?

1. It is best to choose a longitudinal incision, but a transverse incision can also be selected. The length is about 2 to 3 cm. For those who have undergone postpartum ligation, the height of the uterine fundus should be determined. If the uterus is too soft after delivery, gently massage it to harden it. The upper edge of the incision should be two horizontal fingers below the uterine fundus. For those who undergo ligation after menstruation, the lower edge of the incision is two horizontal fingers away from the pubic symphysis (upper edge), that is, 3 to 4 cm.

2. Cut the skin and subcutaneous fat layer by layer, cut the anterior sheath of the rectus abdominis muscle, and bluntly separate the rectus abdominis muscle. Extract the peritoneum, avoid the bladder and blood vessels, and avoid clamping the subperitoneal bowel. The peritoneum was confirmed and cut open to enter the abdominal cavity.

3. When searching for the fallopian tube, you must be steady, accurate and gentle. You can use the following methods to extract the fallopian tube.

(1) Fingerboard method: If the uterus is in the posterior position, first return it to the anterior position. Use your index finger to enter the abdominal cavity and touch the uterus, slide along the uterine horn to the back of the fallopian tube, then insert the pressure plate, place the fallopian tube between the finger and the pressure plate, slide them together to the ampulla of the fallopian tube, and then gently take them out together.

(2) Hook method: Place the hook along the anterior abdominal wall through the bladder-uterine pouch, with the back of the hook close to the anterior uterine wall, slide to the back of the uterine fundus, and then slide to one side of the fallopian tube. After hooking the fallopian tube ampulla, gently lift it up. Under direct vision, use toothless forceps to clamp the fallopian tube and gently lift it out. If the hook feels too tight when lifted, it may hook the ovarian ligament. If it is too loose, it may hook the intestinal flexure.

(3) Oval forceps method: If the uterus is in retroverted position, first return it to the anterior position. After inserting the toothless and buckled oval forceps into the abdominal cavity, slide it along the anterior abdominal wall through the bladder-uterine pouch, over the anterior wall of the uterine body to the uterine horn, then separate the two leaves of the oval forceps, slide it toward the fallopian tube, rotate it inward 900, loosely clamp the ampulla of the fallopian tube, and lift out the fallopian tube.

4. All proposed fallopian tubes must be traced back to the fimbria to confirm that the fallopian tubes are correct. Routine examination of both ovaries.

5. The method of blocking the fallopian tube can be based on local experience, but the method must be effective, simple, and have fewer complications.

2. Male sterilization surgery steps

1. The patient lies on his back with his lower limbs slightly apart.

2. The doctor uses his left thumb, index finger and middle finger to fix the vas deferens on the right side of the patient, open the patient's scrotal skin and push open the spermatic cord vessels. Ligate one side first, then the other side. During this process, the doctor is required to fix the vas deferens with his fingers to prevent it from slipping.

3. The puncture site during the operation is selected at the upper part of both sides of the scrotum. Use a fine needle to puncture the scrotal skin and inject procaine solution.

4. Use vas deferens separator forceps to enlarge the puncture hole.

5. To fix the vas deferens, insert the vas deferens fixing forceps into the skin tear, open the clamp ring, and with the cooperation of the middle finger of the left hand, push the vas deferens into the clamp ring and fasten it.

6. Lift the vas deferens out of the fissure to expose the milky white wall of the vas deferens. Use the vas deferens lifting hook to lift the vas deferens out of the adventitia incision.

7. Separate a 1.5 cm long section of the vas deferens and tie it off with appropriate tightness.

8. Use phenylmercuric acetate to slowly inject spermicidal solution, at which time the patient will feel like urinating.

9. Ligate the distal end of the vas deferens, hold the hemostat to fold the proximal (or distal) end of the vas deferens, and use the proximal (or distal) ligature to ligature again at the folded part.

10. If there is no bleeding after examination, cut the ligature short and return the vas deferens to the scrotum. Cover the puncture site with a small gauze pad.

3. Notes

After a man undergoes a sterilization operation, it does not immediately provide permanent contraception, so other reliable contraceptive measures must be used after the operation. Contraceptive measures can only be abandoned after two sperm tests have proven that there are no sperm at all. In very rare cases, a bisected vas deferens can reopen, restoring fertility.