What is Female Sterilization?

Female ligation is a method of permanent fertility prevention for women of childbearing age through tubal ligation. At present, there are two methods: surgical ligation and drug ligation. Fallopian tube ligation is a permanent method of contraception. It is the main measure to control the rate of population growth.

Female ligation

Female ligation is through

Fallopian tube ligation (surgical sterilization) is to excise a part of the fallopian tube and ligate it so that the sperm and the egg cannot meet to achieve the purpose of contraception. It has a history of more than 100 years, and there are more than 100 kinds of ligation methods. As early as 1833, some people think that hysterectomy and ovaries

There are two indications for tubal ligation: the first point is that the married woman has a child, and the couple volunteers to request sterilization; the second point is if there is a serious heart disease, heart failure, chronic Liver and kidney disease with poor liver and kidney function and certain genetic diseases, women who are not suitable for pregnancy can also perform this operation to achieve the effect of infertility.

Its contraindications are as follows: first, abdominal skin infections and genital infections cannot be done; second, the body is very weak and cannot tolerate this operation, such as postpartum hemorrhage, shock, heart failure, etc .; At three o'clock, continuous temperature measurement is not allowed for those who are above 37.5 degrees twice within 24 hours. Fourth, it is not advisable to do it during pregnancy. Fifth, patients with severe mental illness should postpone surgery.

1. Non-pregnant period should be implemented within 3-7 days of complete menstruation.

2. Surgery can be performed immediately after early or late abortion, and

Ligation of the fallopian tube just cuts off the channel where the eggs and sperm meet. It is a minor operation and may have minor pains and incision infections, but it will not damage and affect the physiological functions of the body, nor will it affect health and sexual life, let alone hurt. What "vitality".

As long as the wound recovers after the operation, the couple's sexual life can be restored, and the operation has absolutely no effect on the couple's sexual life. On the contrary, because they are no longer worried about pregnancy, they can make the couple's sex life more harmonious and happy.

Because it is the ovaries and uterus that affect menstruation and menopause, the ligation operation only cuts the fallopian tubes, and the uterus and ovaries are intact. Therefore, ovulation is the same every month, and menstruation will continue, which will not stop menstruation or affect menstrual flow. There will be no early menopause. It is not necessary to worry about whether the ligation surgery will affect mood or weight. This is because the surgery does not affect the function of the ovaries and can normally secrete female hormones, so it will not affect mood or weight. But there may be very few people who are emotionally affected by excessive tension. As long as the spirit is relaxed and positive, this usually does not happen.

There are two main causes of pelvic discomfort after female sterilization; one is caused by pelvic adhesions, and the other is caused by patients' mental factors.

1. The causes of pelvic adhesions are as follows: (1) rough operation, arbitrary clamping of the fallopian tube, and a large range of damage; (2) inadequate disinfection, which is likely to cause infection; (3) pelvic inflammation already exists before the operation; (4) Pelvic adhesions are also related to the surgical method. Proximal embedding method has less damage to the fallopian mesentery, so there is less adhesion after operation. The wave method and wave modification method often cause more adhesions after tubal injury; (5) pure pursuit of surgical speed and small incisions, large suture and other tissues by mistake; (6) related to the timing of ligation.

2. We can take the following methods to prevent pelvic adhesions: (1) strictly grasp the indications and carefully perform preoperative examination; (2) strictly follow the operating procedures, the operation should be stable, accurate, light, and clear; (3) the best Proximal embedding method with less damage is selected; (4) Anti-adhesion drugs such as antibiotics can be injected into the abdominal cavity before closing the abdomen,

1. It is advisable to choose a longitudinal incision or a transverse incision. The length is about 2 ~ 3cm. For postpartum ligation, the height of the uterine fundus is clear. After the uterus is too soft, massage gently to make it hard. The upper edge of the incision is two horizontal fingers below the uterine fundus. After menstrual ligation, the inferior margin of the incision is 3 to 4 cm away from the two transverse fingers of the pubic symphysis (upper margin).

2. Cut the skin and subcutaneous fat layer by layer, cut the anterior sheath of rectus abdominis, and bluntly separate rectus abdominis. Extract the peritoneum, avoid the bladder and blood vessels, and avoid clamping the subperitoneal intestine. It was confirmed as peritoneum, and it was cut into the abdominal cavity.

3. To find the fallopian tube to be stable, accurate and light, the following methods can be used to extract the fallopian tube.

(1) Fingerboard method: If the uterus is posterior, return to the anterior position first. Use your index finger to enter the abdominal cavity to touch the uterus, slide along the uterine horn toward the back of the fallopian tube, then put the pressure plate, place the fallopian tube between your finger and the pressure plate, slide together towards the tubal pot belly, and then gently remove together.

(2) Hook method: The hook is recessed along the front wall of the abdomen through the bladder and uterus, the back of the hook is close to the front wall of the uterus, slide to the back of the bottom of the uterus, and then slide to the side of the fallopian tube to hook the fallopian tube to the abdomen, Lift gently, hold the fallopian tube with toothless forceps under straight view and gently lift. If the hook feels too tight when it is lifted, it may catch the ovarian ligament. If it is too loose, it may catch the bowel curvature.

(3) Oval forceps: If the uterus is posterior, return to the anterior position first. After entering into the abdominal cavity with toothless and buckle-free elbow oval forceps, slide along the anterior abdominal wall through the anterior wall of the uterus through the bladder and uterine depression to the uterine horn, then separate the two leaves of the oval forceps, slide toward the fallopian tube, and rotate 900 , Virtually clamped the ampulla of the fallopian tube and raised the fallopian tube.

4. The proposed fallopian tubes must be traced back to the umbrella end to ensure that the fallopian tubes are correct. Routine examination of both ovaries.

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

(1) Proximal embedding by core-pulling: Lift the tubal isthmus with two tissue forceps, the distance between the two forceps is about 2 ~ 3.0cm. Select the non-vascular area of the isthmus, first inject a small amount of physiological saline under the serosa to make the serosa layer float, and then cut the serosa in this part to free the fallopian tube. Then clamp the two ends with two mosquito forceps and cut off 1 ~ 1.5cm, ligate the two broken ends with a No. 4 silk thread, and ligate the serous membrane layer at the same time at the distal end.

(2) Silver clamp method: Place the silver clamp on the placing forceps, aiming the forceps mouth at the raised fallopian tube isthmus, so that the transverse diameter of the isthmus enters the two arms of the silver clip, slowly press the handle of the forceps, and press the Upper and lower arms, make the silver clamp press on the fallopian tube, continue pressing for 1 to 2 seconds, then release the upper clamp, and check whether the silver clip is clamped on the fallopian tube flatly.

(3) Fallopian tube ligation and severing method (Mr. Platts modified method): This method is only used when the above methods cannot be performed.

1) Lift the fallopian tube isthmus with a pair of rattooth forceps to fold it.

2) Squeeze the fallopian tube with vascular forceps at a distance of 1.5 cm from the top for 1 minute.

3) Use a 7-gauge silk thread to pass through the mesangium, ligate the proximal fallopian tube first, then surround the distal ligature and, if necessary, the proximal ligature.

4) Cut a section of fallopian tube about 1cm above the ligature.

The contralateral fallopian tube was ligated in the same way.

6. Check the abdominal cavity and the abdominal wall for bleeding, hematoma and tissue damage.

7. Check the gauze and instruments to close the abdominal cavity without error, and suture the abdominal wall layer by layer with silk thread.

8. Cover the wound with sterile gauze.