Complications after tubal ligation surgery

　　1. Incision infection:In this group, 2 cases were mainly caused by potential infection foci in the body, and 6 cases were caused by failure to follow the doctor's advice on medication and failure to pay attention to incision hygiene, among other reasons.

　　2. Abdominal wall hematoma:Mainly occurs in the muscular layer and extraperitoneal pubic posterior space, and is caused by inadequate and incomplete hemostasis.

　　3. Re-pregnancy of the uterus:Among them, 3 cases were double-ligation methods, mainly due to the relatively thick and hard fallopian tubes, loose ligation causing the ligature to slip off; 1 case was a suture resection method, mainly due to less than 1 cm of resected fallopian tube.

　　4. Bladder injury:The main reason is that the bladder was full during surgery, abdominal adhesion occurred, and the inverted peritoneum of the bladder was mistakenly cut as peritoneum.

　　5.附件损伤出血：Mainly caused by inflammation and adhesion of the pelvic cavity, and excessive force.

　　6. Pelvic adhesion:Mainly due to the fact that surgery was performed when the pelvic cavity was inflamed and congested, and preoperative examination was not strict.

　　7. Neurosis:The cause is the surgeon's nervous tension, insufficient understanding of the surgery, and inadequate explanation and comfort by the doctor.

　　Complications after tubal ligation surgery include:

　　1. Abdominal pain:The cause is adhesion between the pelvic cavity and the ligated part of the fallopian tube after surgery. Clinical manifestations include lower abdominal pain and a sense of distension in the abdomen.

　　2. Neurosis:Mostly caused by a lack of understanding of the surgery and nervous tension leading to disorders in the process of excitement and inhibition of the nervous system, and dysfunction of the autonomic nervous system. Clinical symptoms include unstable emotions, depression, discomfort in the chest and abdomen, melancholy, fatigue, menstrual irregularities, loss of appetite, dizziness, palpitations, and restless sleep with frequent dreams.

　　3. Irregular menstruation:The cause is that a few surgeons are not careful during the operation, causing the blood vessels of the ovary and uterus in the fallopian tube system to twist, leading to ovarian hemodynamic disorders. Most cases are caused by other factors and are unrelated to surgery. Clinical manifestations include temporary menstrual cessation, irregular menstrual periods, varying menstrual volume, abdominal distension, and lower back and lumbar pain.

　　4. Incision infection:Mostly caused by factors such as existing infection foci in the body, failure to strictly follow operational procedures during the operation, and insufficient hemostasis. Clinical symptoms include surgical site abscess, tenderness, fever, and in severe cases, pelvic or abdominal infection, sepsis, or even shock.

　　Due to factors such as fistula formation at the ligation site, the formation of a new umbrella, organic lesions, or improper surgery, a very small number of patients may experience varying degrees of early or late complications, such as peritoneal abscesses.

　　Strengthening the concept of aseptic operation, necessary preoperative examinations, mastering the indications and contraindications of surgery, communication with the operator; careful examination and careful operation during surgery; careful nursing after surgery are the key to reducing complications after tubal ligation surgery. And it is more important to prevent complications than to treat them, and treatment should also focus on the key points.

　　In addition to the routine clinical manifestations, related examination methods are also indispensable for the diagnosis of complications after tubal ligation surgery. Ovarian function tests, fallopian tube patency tests, and fallopian tube hysterosalpingography.

　　1. What foods should be eaten after tubal ligation surgery for the prevention of complications to benefit the body

　　Diet should be light, with an emphasis on vegetables and fruits, a reasonable diet, and adequate nutrition.

　　2. What foods should be avoided after tubal ligation surgery for the prevention of complications

　　Avoid smoking, drinking, spicy foods, greasy foods, and smoking. Avoid cold and raw foods.

　　(The above information is for reference only; for details, please consult a doctor.)

　　1. Strictly adhere to aseptic operation. The data show that the vast majority of complications from tubal ligation surgery are incision infections, and the main reason is the operator's neglect of medical advice. Therefore, the preoperative and postoperative education of the operator on the importance of medical advice is an indispensable step. Initial treatment includes anti-infection, hot compress, physical therapy, and comprehensive treatment. Oral fleroxacin 0.2g is taken for 4 consecutive days, and the incision is treated with alcohol gauze. In one case, an abscess had formed, and the suture was removed prematurely, the abscess was aspirated, and the dressing changed to allow inflammation to subside and pus to be absorbed, resulting in recovery.

　　2. To prevent the occurrence of abdominal wall hematoma, it is required to stop bleeding completely during the operation, and no bleeding point should be overlooked. One cannot be careless due to the pursuit of speed. Abdominal wall hematoma is often found 2-5 days after surgery, with significant tenderness and swelling at the incision site. Treatment includes aspiration and needle puncture, incision opening, removal of blood clots, and anti-inflammatory therapy.

　　3. The selection of the operation time, ligation method, and correct identification of the fallopian tube are crucial for reducing the risk of secondary pregnancy. The best operation time is 3-7 days after menstruation, 24 hours after delivery and mid-term induction, after the first menstrual period following abortion or spontaneous abortion, during lactation amenorrhea (excluding early pregnancy), or after the removal of the birth control device, as the fallopian tubes are least congested at this time, the ligation is more solid, and the risk of re-passage of the tube is reduced, which can reduce intraoperative bleeding and shorten the operation time. Generally, the preferred ligation method is to use the core embedding method or double-layer ligation incision. When using the core embedding method, the distance between the two ends should be at least 1 cm to prevent re-passage of the lumen. The suture thread is generally recommended to be 7号线, and the tension should be moderate. In addition, it should be avoided to pierce through the fallopian tube lumen when threading the needle to prevent the mucosa from growing along the suture line, forming a new ostium, which may create an opportunity for re-pregnancy. When extracting the fallopian tube, the ostium must be seen, and the operation can then be performed in the 1/3 avascular area outside the isthmus. Women who become pregnant again must undergo a re-ligation operation after induction.

　　4, Preoperative routine bladder emptying, the height and size of the incision must be determined according to the size of the uterus; for a normal or slightly larger uterus, the incision should be at 3cm above the pubic symphysis; it is necessary to accurately distinguish the peritoneum and bladder tissue, the peritoneum is thin without muscle, with fat attached, and few blood vessels; while the bladder is thicker, with smooth muscle, and rich blood vessels. Bladder injury should be repaired immediately and a catheter should be placed for one week.

　　5, Necessary preoperative examinations, mastering the indications and contraindications of surgery, careful examination and careful operation during the operation are the main measures to prevent附件 damage and bleeding, pelvic adhesion, and cannot be overconfident. For the bleeding caused by附件 damage, repair and ligation for hemostasis should be performed, and for pelvic adhesion, mainly the adhesion of fallopian tubes and ovaries, uterus, and round ligament, the treatment must take corresponding measures, or resect the focus, or carry out corresponding treatment, which depends on the condition.

　　6, Neurosis mainly refers to the disorder of the excitation and inhibition process of the nervous system after surgery, which is often manifested as non-organic headaches, abdominal pain, back pain, and other symptoms. The prevention of this complication mainly involves doing the ideological work of the patients, propagating the significance of family planning, explaining in detail the relationship between sterilization and the body, eliminating their concerns, stabilizing their tense emotions, and avoiding all kinds of adverse stimulation. Treatment mainly involves eliminating doubts, making patients believe in the relevant examinations, not relying too much on medication, and selecting traditional Chinese medicine with the functions of soothing the liver and regulating the qi, promoting blood circulation and hemostasis, such as prepared cyperus, Corydalis, safflower, Angelica sinensis, white peony, finger citron, bupleurum, licorice, and huoxiu, which can help regulate emotions and relieve pain.