4.         Look at the illustration.

a)         What procedure is being carried out?

            Tubal ligation. Application of a filshie tube.

b)         As a doctor, what must you ensure prior to the procedure?

            Patient is not pregnant at time of ligation.

c)         If you are doing the procedure, what 2 steps would you take to ensure that the operation is a success?

            Ensure the correct structures are identified.

            Complete occlusion of the whole tube.

            Ensure clip is applied tightly around tube.

d)         What is the likely failure rate of this procedure?

            0.1 – 0.2%

e)            Besides failure rate, what 2 specific important issues would you counsel the patient undergoing this procedure?

            Risk of ectopic pregnancy. It is a irreversible method.