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  • Title: Tubal ligation by colpotomy incision.
    Author: Whitaker CF.
    Journal: Am J Obstet Gynecol; 1979 Aug 15; 134(8):885-8. PubMed ID: 463993.
    Abstract:
    A five-year review of colpotomy tubal ligation performed on 585 patients within a private-practice setting in Columbus, Georgia, is analyzed. Operative time averaged under 30 minutes, and average hospital stay was less than 3 days. The major postoperative complication rate was less than 2%. The patient population is reviewed as to age, parity, previous contraception, and medical indications for sterilization. Surgical technique is discussed, and several suggestions are made, A follow-up of subsequent gynecologic procedures and the interval following colpotomy is then presented. A 5-year review of colpotomy tubal ligation performed on 585 patients within a private practice setting in Columbus, Georgia is analyzed. The patients ranged in age from 16-46; parity ranged from 0-6, with a mean parity of 2. 78 or 13% of the patients were pregnant and underwent concomitant therapeutic abortion by suction curettage at the time of colpotomy. The majority of the patients presented for elective sterilization, but 11.7% presented for medical reasons. A right-angled Haney retractor was placed in the open cul-de-sac, and the fallopian tube was grasped with a Babcock clamp and identified up to the fimbria. The tube was then ligated in a Pomeroy fashion using 1-0 plain suture material, with the tubal segments submitted for evaluation. The posterior peritoneum was closed in a nonlocking manner, and the same suture material was then continued in a locking fashion for closure of the vaginal cuff. Hospital stay ranged from 2-7 days; average hospital stay was 2.5 days per patient. Surgical operative time ranged from 15-60 minutes with an average time of 25.7 minutes. Laparotomy was required for ligation of tubes in 8 patients. 9 patients experienced postoperative complications which contributed to prolongation of hospital stay and morbidity. Vaginal cuff hematoma and cuff abscess requiring incision and drainage were absent. Tubal ligation through vaginal colpotomy incision has proved to be an effective and efficient method of sterilization. Attention to surgical hemostasis, concomitant curettage, and early ambulation are believed to contribute to the low instance of operative complications.
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