The most Common site of tubal sterilization is –
Correct Answer: Isthmus
Description: Ans-B i.e., Isthmus o Most commonly performed method of female sterilization is Pomeroy's method.o The part of the fallopian tube is ligated and excised in Pomeroy's method is isthmus.a) Pomeroy's Method - Through an avascular area in the mesosalpinx, a needle threaded with No. "0" chromic catgut is passed and both the limbs of the loop are firmly tied together. About 1-1.5 cm of the segment of the loop distal to the ligature is excised. The tube is so excited as to leave behind about 1.5 cm of the intact tube adjacent to the uterus.# The segment of the loop removed is to be inspected to be sure that the wall has not been partially resected and to send it for histology.b) Uchida technique - A saline solution is injected subserosally in the mid-portion of the tube to create a bleb. The serous coat is incised along the antimesenteric border to expose the muscular tube. The tube is ligated with No. 0 chromic catgut on either side and about 3-5 cm of the tube is resected off. The ligated proximal stump is allowed to retract beneath the serious coat. The serous coat is closed with a fine suture in such a way that the proximal stump is buried but the distal stump is open to the peritoneal cavity. No failure in this method has been observed so far.c) Irving method - The tube is ligated on either side and mid portion of the tube (between the ties) is excised. The free medial end of the tube is then turned back and buried into the posterior uterine wall creating a myometrial tunneld) Madlener technique - It is the easiest method. The loop of the tube is crushed with an artery forceps. The crushed area is tied with black silk. The loop is not excised. The failure rate is very high to the extent of 7% and hence, it is abandoned in preference to the Pomeroy's technique.e) Kroener method of fimbriectomy is not a common procedure.
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