Today after 3 months i entered Operation Theatre. I had to assist in Tubal Ligation operation by Laparotomy. Both for surgeon and for me it was doing an operation after a long hiatus. For almost more than decade Laparoscopic T.L. is preferred method. But once in while we get a patient who prefers this open method with almost nil chances of failure. For surgeon this operation is more difficult than Lap.TL, takes longer to perform.
when i joined as Resident in OB/GYN yrs ago.T.L. after Delivery was the First operation a Resident would get to do.After 2-3 operations, he was expected to do it on his own with only a Nurse to assist. Every operation day would have at least 4-5 T.L.s. Today the scenario has changed completely. TL is not preferred method. Among my friends and colleagues, i dont think anyone has undergone TL op. In our practice also number of TL op. have gone down drastically and after delivery ( once a preferred time) no one advises TL. If TL is to be done than Interval Lap TL is preferred method. This must be real spanner in achieving targets for Family Planning staff. Lap TL requires costly equipments and trained Doctors. ---PK