STERCULIA
S
FEMALE STERILIZATION
Laparoscopic sterilization (below)
is the most common method. Both
fallopian tubes must be cut, sealed,
or obstructed so that eggs and
sperm cannot meet for fertilization.
Sterilization is usuallypermanent.
Laparoscopic sterilization
An endoscope (viewing tube) and an
operating instrument are passed through
separate small incisions in the abdomen.
Cutting
A small loop of the
fallopian tube may be
drawn up, secured by
a tight ligature, and
then cut off.
Constriction
A loop ofthe fallopian
tube may be constricted
at the base bya tight
band, preventing eggs
from passing through.
Clipping
A plastic or metal clip
maybe applied to the
fallopian tube, sealing
it so that eggs cannot
pass through.
Cautery
Electrocoagulation
(diathermy) can be
used to burn through,
and thus seal, the
fallopian tube.
Cannula
Instruments
The trocar is a sharp-pointed
inner stylus surrounded bya
close-fitting tube, the cannula.
The instrument can be passed
through the abdominalwall.
After insertion, the trocar
is removed, leaving the
hollow cannula in place.
Other instruments are
passed through the
hollow cannula.
s te r c u lia
A b u l k - f o r m i n g
la xa tiv e
t h a t i s u s e d t o
t r e a t c o n s t i p a t i o n . S t e r c u l i a i s e s p e c i a l l y
u s e f u l w h e n s t o o l s a r e s m a l l a n d h a r d .
H o w e v e r , i t s h o u l d o n l y b e u s e d i f f i b r e
i n t a k e c a n n o t b e i n c r e a s e d . D u r i n g t h e
u s e
o f s t e r c u l i a , a d e q u a t e
f l u i d i n t a k e
m u s t b e m a i n t a i n e d t o a v o i d i n t e s t i n a l
o b s t r u c t i o n .
S i d e
e f f e c t s
m a y
i n c l u d e
f l a t u l e n c e , b l o a t i n g , a n d g a s t r o i n t e s t i n a l
o b s t r u c t i o n o r i m p a c t i o n .
s te re o ta x ic s u r g e ry
B r a i n o p e r a t i o n s t h a t a r e c a r r i e d o u t b y
t h e
i n s e r t i o n
o f d e l i c a t e
i n s t r u m e n t s
t h r o u g h a s u r g i c a l l y c r e a t e d h o l e i n t h e
s k u l l a n d g u i d i n g t h e m
, w i t h t h e a i d
o f
C T s c a n n in g ,
t o
a
s p e c i f i c
a r e a .
S t e r e o t a x i c p r o c e d u r e s c a n b e u s e d t o
t r e a t
p it u it a r y t u m o u rs ;
f o r
a
b r a i n
b io p s y ;
o r t o d e s t r o y s m a l l a r e a s o f t h e
b r a i n a s t r e a t m e n t f o r s o m e d i s a b l i n g
n e u r o l o g i c a l d i s o r d e r s .
s te r ile a b s c e s s
A n
a b s c e s s
i n w h i c h t h e
c o n t e n t s a r e
n o t p y o g e n i c ( p u s - f o r m
i n g ) a n d t h e y
d o
n o t
g r o w
b a c t e r i a
w h e n
c u l t u r e d
( s e e
c u ltu re
) .
s t e r ilit y
T h e s t a t e e i t h e r o f b e i n g g e r m
- f r e e o r
o f p e r m a n e n t
in f e rt ilit y
.
s te riliz a tio n
C o m p l e t e d e s t r u c t i o n o r r e m o v a l o f l i v -
i n g
m i c r o o r g a n i s m s ,
w h i c h
i s
u s u a l l y
c a r r i e d
o u t
t o
p r e v e n t
t h e
s p r e a d
o f
i n f e c t i o n . T h e t e r m a l s o r e f e r s t o a p r o -
c e d u r e
t h a t r e n d e r s
a p e r s o n i n f e r t i l e .
( S e e a l s o
s te riliz a tio n , f e m a le
;
v a se c to m y
. )
s te r iliz a tio n , fe m a le
A u s u a l l y p e r m a n e n t m e t h o d o f
c o n tra -
c e p tio n
i n w h i c h t h e f a l l o p i a n t u b e s a r e
s e a l e d i n o r d e r t o p r e v e n t s p e r m f r o m
r e a c h i n g t h e o v a . F e m a l e s t e r i l i z a t i o n i s
u s u a l l y
p e r f o r m e d
b y
la p a ro s c o p y ,
a
p r o c e d u r e t h a t i n v o l v e s t w o s m a l l i n c i -
s i o n s
i n
t h e
a b d o m e n .
S o m e t i m e s
i t
i s
p e r f o r m e d
b y
m i n i l a p a r o t o m y ,
i n
w h i c h a s i n g l e i n c i s i o n i s m a d e i n t h e
p u b i c
a r e a .
T h e
f a l l o p i a n
t u b e s
a r e
s e a l e d
u s i n g
c l i p s
o r
b y
c u t t i n g
a n d
t y i n g . T h e o p e r a t i o n s h a v e a l o w f a i l u r e
r a t e .
A l t h o u g h
s t e r i l i z a t i o n
i s
u s u a l l y
p e r m a n e n t ,
f e r t i l i t y c a n s o m e t i m e s b e
r e s t o r e d u s i n g
m ic r o s u r g e r y
.
s te r iliz a tio n , m a le
S e e
v a s e c to m y
.
s t e r iliz e r
A
p i e c e
o f a p p a r a t u s
t h a t
i s
u s e d
t o
m a k e
m e d i c a l
e q u i p m e n t
s te rile .
( S e e
a l s o
a u t o c la v e
. )
ste rn u m
T h e l o n g , n a r r o w , f l a t p l a t e o f b o n e a t
t h e f r o n t o f t h e c h e s t . T h e s t e r n u m c o n -
s i s t s
o f
t h e
m a n u b r i u m
( u p p e r m o s t
p a r t ) ; t h e b o d y ( l o n g m i d d l e p a r t ) ; a n d
t h e x i p h o i d p r o c e s s , o r x i p h i s t e r n u m ( a
s m a l l , l e a f - s h a p e d p r o j e c t i o n ) . T h e t o p
o f
t h e
s t e r n u m
a r t i c u l a t e s
w i t h
t h e
i n n e r e n d s o f t h e
c la v ic le s
( c o l l a r b o n e s ) .
712
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