One in three women of reproductive age utilize tubal sterilization for contraception, and sterilization is often requested at time of cesarean delivery. Complete salpingectomy for the purpose of permanent sterilization at the time of cesarean birth is increasingly being performed worldwide. A preferred complete salpingectomy technique for the purpose of sterilization at the time of cesarean delivery has not emerged in current practice. The objective is to compare short-term clinical outcomes and cost of salpingectomy using a hand-held bipolar energy instrument with those of traditional suture ligation. This retrospective cohort study will be conducted from 2017-2023 at a single tertiary care hospital. The investigators hypothesize that bipolar energy instrument use will not significantly improve clinical outcomes.
Study Type
OBSERVATIONAL
Enrollment
900
A bipolar energy instrument is used for complete salpingectomy at the time of cesarean delivery.
Traditional suture ligation technique is used for complete salpingectomy at the time of cesarean delivery.
Inova Fairfax Medical campus
Falls Church, Virginia, United States
RECRUITINGChange in Hemoglobin levels on postoperative day one
Change in hemoglobin levels reported in gram per deciliter on postoperative day one, calculated as the difference between immediate preoperative and postoperative day 1 hemoglobin levels
Time frame: preoperatively and one day after surgery
Completion rate of sterilization
Proportion of sterilization procedure completed by postoperative day one
Time frame: preoperatively and one day after surgery
Total procedure estimated blood loss
estimated blood loss calculated and documented in milliliters at the end of the procedure
Time frame: intraoperatively
Adjacent organ damage
Rate of injury to abdominal/pelvic organs sustained during the procedure
Time frame: intraoperatively
Need for blood transfusion
any need for blood products transfusion intraoperatively through discharge
Time frame: from day of surgery up to 30 days pospartum
Total operative time
time necessary to complete the surgery from skin incision to end of skin closure
Time frame: intraoperatively
ICU admission
any admission to the intensive care unit for procedure-related complications
Time frame: from day of surgery up to 7 days postpartum
Length of hospital stay
Duration of hospitalization in days from admission to discharge
Time frame: from day of surgery up to 6 weeks postpartum
Hospital readmission postoperatively
Any admission after initial discharge from the hospital
Time frame: Day of initial dischage through 6 weeks postpartum
Reoperation rates
Number of participants who return to the operating room due to initial procedure-related complications
Time frame: postoperative day 0 through 6 weeks postpartum
Pain score
pain severity measured on a scale of 0 through 10
Time frame: from day of surgery up to 7 days postparum
Surgical site infection
any infection that occurs post-surgery in the abdomen, pelvis, abdominal walls or skin
Time frame: postoperative day 0 through 6 weeks postpartum
Cost
cost difference between bipolar instrument and suture
Time frame: intraoperatively
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