Operative Report

PATIENT: Sarah Jenkins DATE OF PROCEDURE: 1 November 2024 SURGEON: Dr. Anya Sharma ASSISTANT: Dr. Ben Carter PAEDIATRICIAN: Dr. Emily White PROCEDURE: Elective Caesarean Section with Bilateral Tubal Ligation INDICATION FOR PROCEDURE: Previous Caesarean section, maternal request for repeat Caesarean, and completed family desiring permanent contraception. FINDINGS: * Healthy, term male infant delivered without complications. * Uterus well-contracted post-delivery. * Fallopian tubes appeared normal prior to ligation. * Minimal blood loss. PROCEDURE DETAILS: Following administration of spinal anaesthesia, the patient was prepped and draped in a sterile fashion. A Pfannenstiel incision was made, and dissection was carried down through the subcutaneous tissue to the fascia, which was incised transversely. The rectus muscles were separated in the midline, and the peritoneum was entered sharply. A low transverse hysterotomy was performed, and a healthy male infant was delivered via vacuum assist due to a nuchal cord x1. The cord was clamped and cut, and the infant was handed to the paediatric team. The placenta was delivered manually, and the uterus was closed in two layers with absorbable suture. Following uterine closure, bilateral fallopian tubes were identified, ligated, and transected using the modified Pomeroy technique. Haemostasis was confirmed throughout the procedure. The abdomen was irrigated, and the fascial layer was closed with interrupted sutures. Subcutaneous tissue was approximated, and the skin was closed with a running subcuticular suture. Estimated blood loss was 500ml. Sponge and instrument counts were correct. POST-OPERATIVE PLAN: * Routine post-operative monitoring in recovery. * Early ambulation encouraged. * Pain management with oral analgesics as per protocol. * Monitor for signs of infection or haemorrhage. * Continue breastfeeding support. * Follow-up appointment scheduled for 6 weeks post-partum for incision check and general well-being assessment.