Female
Sterilization
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.
A new method is
presented 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.
- 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 lpies
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.