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Karl Daniel, M.D.
Karl Daniel, M.D.
1  sur  17
David Blair Toub, M.D. Dept. of Obstetrics and Gynecology Pennsylvania Hospital
Overview: ,[object Object],[object Object],[object Object],[object Object]
Considerations: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Potential Benefits: ,[object Object],[object Object],[object Object],[object Object]
Complications: ,[object Object],[object Object],[object Object],[object Object]
Options: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],* can be done immediately postpartum laparoscopic
The Filshie Clip: ,[object Object],[object Object],[object Object]
CREST Study, 1996: ,[object Object],[object Object],[object Object],[object Object],[object Object],Peterson, HB, et al Am J Obstet Gynecol 1996;174:1161-1170
Ten-Year Cumulative Probability of Pregnancy (per 1000 procedures) method 24.8 7.5 17.7 36.5 20.1 7.5 18.5 probability per 1000 procedures
Tubal Ligation Failures: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Management of TL Failures: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Monopolar Vs. Bipolar Electrosurgery: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],monopolar bipolar failure rate risk of bowel burns ground needed?
Strategies to Minimize Bipolar Electrosurgery Failures: ,[object Object],[object Object],[object Object],[object Object],Soderstrom RM, Levy BS, Engel T. Obstet Gynecol 1989;74:60-3
Vasectomy: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tubal Reanastamosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Secondary Sterilization: ,[object Object],[object Object],[object Object],[object Object]
Conclusions: ,[object Object],[object Object],[object Object],[object Object],[object Object]

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sterilization

  • 1. David Blair Toub, M.D. Dept. of Obstetrics and Gynecology Pennsylvania Hospital
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  • 9. Ten-Year Cumulative Probability of Pregnancy (per 1000 procedures) method 24.8 7.5 17.7 36.5 20.1 7.5 18.5 probability per 1000 procedures
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Notes de l'éditeur

  1. postpartum TL may have slightly higher failure rate vaginal TL is effective, but limited by inc risk infection hysterectomy is no longer recommended as a primary means of sterilization in the absence of additional indications. Rare pregnancies have resulted post-hysterectomy fimbriectomy-higher failure rate, hydrosalpinx formation hysteroscopic monopolar electrosurgery used to be done and was technically not very difficult, but was abandoned due to cornual perforations and bowel burns. Discuss bipolar vs monopolar, and higher failure rate w bipolar
  2. cutting waveform better than coag ammeter not always reliable failures require reoperation, with attention directed towards proximal stump avoid surgery close to cornua-higher fistula rate