Page 26 - World Journal of Laparoscopic Surgery

Is Previous Abdominal or Pelvic Surgery a Risk Factor?
4
by Cochrane, there were 11 procedure-related complications in
laparoscopic sterilization which was nil in our study. As per the
study in women with two or more cesarean-section laparoscopic
sterilization is safe and associated with low morbidity and can be
performed as permanent method of sterilization if extra care is
taken and is in part with study conducted by Ghoshal et al. 5

conclusIon
As in comparison with open tubal ligation, LTL would prevent
larger abdominal incisions, longer hospital stay, and has fewer
complications associated as noted by our study. Selection of cases,
preoperative preparation, adequate experience of operating
surgeon, proper functioning, maintenance of equipment, post-op
care, as well as follow-up has to be kept in mind while following
Fig. 4: Peritubal adhesions camp approach to make the procedure more popular and safe in
developing countries like India. Team-based healthcare approach,
which includes district medical officer to identify lacunae in
the availability of service providers for regular laparoscopic-
sterilization procedures along with training of gynecologist,
OT staff, and anesthetists in female laparoscopic sterilization,
would largely achieve population stabilization and will promote
standards on sterilization services in ensuring the provision of
quality services.

references
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Fig. 5: Comorbidities of associated population abdominal surgery and significant adhesions in laparoscopic
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2527989.
dIscussIon 4. Minilaparotomy or Laparoscopy for Sterilization: A Multicenter,
Concurrent surgical evacuation with laparoscopic sterilization is Multinational Randomized Study. World Health Organization, Task
a simple, safe, and economic procedure for a group of patients Force on Female Sterilization, Special Programme of Research,
demanding combined abortion and immediate surgical sterilization Development and Research Training in Human Reproduction. Am J
Obstet Gynecol 1982;143(6):645–652. PMID: 6211987.
3
as in our study. As per the study by Szigetvari et al., 23% of them 5. Ghoshal AA, Agrawal SD, Sheth SS. Laparoscopic tubal sterilization
had abdominal adhesions with previous abdominal surgery after two or more cesarean sections. J Am Assoc Gynecol Laparosc
which is comparable with our study as it is 19.5%. As per a review 2003;10(2):169–171. DOI: 10.1016/s1074-3804(05)60293-9.

122 World Journal of Laparoscopic Surgery, Volume 15 Issue 2 (May–August 2022)