bilateral tubal ligation method???

• bilateral tubal ligation method??? - gigi
  • Stedman's shows Parkland tubal ligation (nm) - wimt

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Laparoscopic Bilateral Tubal Ligation Report

Preoperative Diagnosis: Multiparous female desiring permanent sterilization.

Title of Operation: Laparoscopic bilateral tubal ligation with Falope rings

Laparoscopic Bilateral Tubal Ligation

Anesthesia: General endotracheal

Findings At Surgery: Normal uterus, tubes, and ovaries.

Description of Operative Procedure

After informed consent, the patient was taken to the operating room where general anesthesia was administered. The patient was examined under anesthesia and found to have a normal uterus with normal adnexa. She was placed in the dorsal lithotomy position and prepped and draped in sterile fashion. A bivalve speculum was placed in the vagina, and the anterior lip of the cervix was grasped with a single toothed tenaculum. A laparoscopic bilateral tubal ligation uterine manipulator was placed into the endocervical canal and articulated with the tenaculum. The speculum was removed from the vagina.

An infraumbilical incision was made with a scalpel, then while tenting upon the abdomen, a Verres needle was admitted into the intra-abdominal cavity. A saline drop test was performed and noted to be within normal limits. Pneumoperitoneum was attained with 4 liters of carbon dioxide. The Verres needle was removed, and a 10 mm trocar and sleeve were advanced into the intra-abdominal cavity while tenting up on the abdomen. The laparoscope was inserted and proper location was confirmed. A second incision was made 2 cm above the symphysis pubis, and a 5 mm trocar and sleeve were inserted into the abdomen under laparoscopic visualization without complication.

A survey revealed normal pelvic and abdominal anatomy. A Falope ring applicator was advanced through the second trocar sleeve, and the left Fallopian tube was identified, followed out to the fimbriated end, and grasped 4 cm from the cornual region. The Falope ring was applied to a knuckle of tube and good blanching was noted at the site of application. No bleeding was observed from the mesosalpinx. The Falope ring applicator was reloaded, and a Falope ring was applied in a similar fashion to the opposite tube. Carbon dioxide was allowed to escape from the abdomen.

The instruments were removed, and the skin incisions were closed with #3-O Vicryl in a subcuticular fashion. The instruments were removed from the vagina, and excellent hemostasis was noted. The patient tolerated the procedure well, and sponge, lap and needle counts were correct times two. The patient was taken to the recovery room in stable condition.

I found a bunch of techniques, but not this one.

Remember it from the "olden days" when I typed radiology from MD direct!!! On a little index-size card!!

Here are some refs:

Scoliosis

The rib hump in idiopathic scoliosis. Measurement, analysis and ...

A New Twist

Recal Information Services

Anyone ever heard of this?? Used in radiology report (scolioisis series). We cannot find any info on this--someone here thinks it's "Cobb" . . . ??? Sounds very much like "cod" No one is sure. Sentence reads: "There is a scoliois to the left. Using the method of Lipmann and Codd the angulation would measure 17 degrees".

Perhaps it's a mathematical term but cannot find anything on this.

HELP-- we've been typing it for years: Lipmann and Codd

I know I've heard it before but I can't document it...

thanks in advance.

Radiographs of a thoracolumbar scoliotic curve that is approximately 15 degrees on the "Simpson" method. 

TYI!

how do you hand bilaterally.  I am very confused on the singular and plural regarding these because doctors say it both ways. 

For example, examination of the hip, knee, and ankle is normal bilaterally...singular.

So, is it always singular when you use these words? or an equivalent (left and right lower extremity or extremities, etc)

I have been doing this for 3 months but this seems to keep coming up and i am hearing it dictated both ways.  Thanks ahead of time for any help :)