Journal of Postgraduate Medicine: Back issue statistics

This paper describes the results of 23 cases of puerperal laparoscopic sterilization performed within 72 hours of delivery. A new method was employed to avoid injury to the uterine fundus and to make the tubes more accessible. Before insertion of the Veress needle, the anterior and posterior lips of the cervix were held with forceps and Hulka's uterine manipulator was introduced into the uterine cavity. The uterus was pulled down toward the introitus by applying traction to the sponge-holding forceps. Pneumoperitoneum of 3-4 liters was induced through use of a Veress needle, followed by introduction of a Storz single puncture operative laparoscope through an incision in the lower umbilical fold. Tubal occlusion was achieved with silastic bands. The average time required for sterilization from induction of general anesthesia was 6 minutes. There was no instance of injury to the uterine fundus, nor were there any cases of uterine perforation, injury to other pelvic structures, laceration of the cervix, or puerperal sepsis. At the time of follow-up 15 days after the procedure, all patients were in satisfactory condition. It is concluded that this method can enhance postpartum family planning programs. Since it can be carried out within the 1st 48 hours after delivery, the routine hospital stay of 3 days does not have to be prolonged as a result of sterilization.