A 37-year-old woman P3L3 attains Family planning Clinic with a strong desire for female sterilization. She gives history,that previous deliveries are caesarean deliveries…
She also gives history of
Intra Caeserean insertion of IUCD during her second delivery.
Following 2 years of insertion ,She underwent laparoscopic retrieval of IUCD due to perforation …
Recently ,she has had a ruptured appendicitis …
On examination(GPE) ,
BP=120/90mmhg,
PR=86bpm…
Mildly anemic …
No other significant findings …
Per abdomen examination reveals multiple abdominal scars noted …
No significant Pelvic examination findings …
Which of the following
is the best surgical approach in this patient?
A. Laparoscopic Falope ring
B. Laparoscopic electrocautery
C. Hysteroscopic approach
D. Minilaparotomy with tubal occlusion…
Answer: “C” Hysteroscopic approach
Here ,the patient underwent
- 2 caesarean sections
2)Laparoscopic surgery(IUCD retrieval)
3)surgery for ruptured appendicitis…
Nearly 3 to 4 abdominal scars …
Such abdomen is not suitable for laparoscopy, Minilaparatomy…
Hysteroscopic use of coils in the tubal ostia (Essure) is a good option for above patients to avoid entry to abdominal cavity,because of
Extensive abdominal adhesions and multiple prior abdominal surgeries…
A hysterosalpingogram is recommended following the procedure to ensure that the tubes are occluded…