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Re: Post-partum SterilizationFrom: Paul Prior MD (pprior@fast.net)Sun May 31 19:20:29 1998
>In message <199805311811.NAA26763@talk.obgyn.net>, Calvin J. Siegers, MD FACOG writes: > >> i've done over 200 pp tubals with zero pregnancies (ectopic or >> overwise). I have seen 1 iup and 1 ectopic referred from other >> docs. With the easy availability of continuous epidurals in labor, >> it now makes it especially convenient to proceed to pp tubal several >> hours after delivery. Like many others, I excise a 2cm segment of >> midportion, then tie the cut ends with silk. Cal > >That's not the issue, I was concerned about Laparoscopic TL post >partum. > >I have done a similar number of BTL (minilap) without comebacks using >Pommeroy's method (chromic) but with an additional silk around the >proximal tube :-)-O We do them with just plain gut around the loop (mod pomeroy) or cut and plain gut on each end separately (parkland). Either way just plain gut. Silk seems a bit extreme - much more reactive and would seem to offer increased risk of fistula (just theoretical, no data...).
-- Paul Prior MD pprior@fast.net Don't Blame Me... PGY-IV Ob/Gyn I Voted For Bob Dole TRHMC-Reading, PA
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