26 Sunday May 2019
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Prior scrubbing with antiseptic.

Shaving the Left Flank Area

Scrubbing the site with povidon.

Local infiltration of lidocaine hydrochloride in inverted L block pattern.

30 cm skin incision parallel to last rib 5-8 fingers away in oblique direction.

Cutting of muscles layer.

Cutting of muscles layer

Exposure of peritoneal adipose layer.

Exposure of peritoneal adipose layer

Dissection through adipose layer.

Dissection through adipose layer

Cutting of peritoneum.

Cutting of peritoneum

Bringing out the left uterine horn.

Bringing out the left uterine horn

Left uterine horn is grasped over a fetal extremity and brought to the operative site.

Left uterine horn is grasped over a fetal extremity and brought to the operative site

Incision is given over the greater curvature.

Incision is given over the greater curvature

Fetus is removed with the help of assistance.

Fetus is removed with the help of assistance

The fetal membranes were removed at the time of surgery if they were lying free within the uterus or could be readily detached.

The fetal membranes were removed

Both ends incision are held by uterine forceps.

Both ends incision are held by uterine forceps

Uterine incision is closed by single layer of uterect suture pattern using chromic cat gut no 2.

Uterine incision is closed by single layer of uterect suture pattern using chromic cat gut no 2

Correction of torsion if present.

Correction of torsion if present

Washing with normal saline.

Washing with normal saline

The uterus was replaced back in the abdominal cavity.

The uterus was replaced back in the abdominal cavity

The abdominal cavity was inspected for large blood and fibrin clots, which were carefully scooped out by hand. Water soluble antibiotic solution of penicillin streptomycin (50-60 ml) was poured within the abdominal cavity.

The abdominal cavity

The peritoneum and muscle layers are closed separately using continuous lockstitch sutures using chromic catgut no. 4.

The peritoneum and muscle layers

Upper and lower should be carefully closed. Don’t leave any dead space in between layers.

Upper and lower should be carefully closed

After closure of each layer it is washed wends ith normal saline and antibiotic is instilled.

After closure of each layer it is washed wends

The skin is closed with mattress sutures using sterile silk (USP no. 3).

The skin is closed with mattress sutures using sterile silk