(2) Each tube is delivered and grasped with two Babcock forceps and
clamped with two Crile forceps.
(3) The section between the Babcock forceps is resected with Metzenbaum
scissors and saved as a specimen. Each tube is doubly ligated with silk sutures
number 2-0 about I inch from the uterine cornu. The sutures on the proximal end of the
tube are left long. This tubal stump is then mobilized by dissecting it free from the
(4) A very small cut is made in the serosa on the posterior surface of the
uterus near the cornu, and the musculature is penetrated with a Crile forceps for about
1/2 inch, spreading the clamp sufficiently to admit the tube.
(5) One of the ligatures attached to the tubal stump is threaded on a needle,
sutured to the bottom of the pocket and carried out to the uterine surface. The other
suture attached to the tubal stump is treated in a similar manner. Traction is placed on
the sutures, thus the tubal stump is buried in the uterine musculature.
(6) The sutures are tied together, and silk sutures number 4-0 are used to
close the edges of the pocket more tightly about the tube. The end of the tube may also
be buried within the leaves of the broad ligament.
The abdominal incision is closed in layers and the wound dressed.
2-44. CESAREAN SECTION
(1) This operation involves the delivery of an infant through an incision
made in the abdominal and uterine walls. This procedure is indicated in instances of
previous section, primary and secondary uterine dystocia, cephalopelvic disproportion,
placenta previa, abruptio placentas, toxemia, fetal distress (prolapsed cord), diabetes,
Rh sensitization, tumors, previous vaginal surgery, abnormal presentation, and many
others. In some instances, the cesarean section may be scheduled according to the
estimated date of confinement, estimated fetal weight, and definite auscultation of fetal
heartbeat at or before 20 weeks from the last menstrual period. At other times,
Cesarean section may be performed on an emergency basis.
(2) Several methods for abdominal delivery are accepted: classic cesarean
section, low or cervical cesarean section, extraperitoneal operation, and cesarean
hysterectomy. The low segment section is today considered standard; however, the
classic method may be chosen in some circumstances.