Surgical Details of Procedure<\/b><\/p>\n
1. A transverse (side to side) skin incision is made at the level of the pubic bone with a No. 10 scalpel. A midline incision can also be used.<\/p>\n
2. Bovie cautery is used to dissect through the subcutaneous tissue to the bilateral rectus muscles.<\/p>\n
3. The rectus muscles and the accompanying fascia are then incised with lateral retraction of each muscle belly.<\/p>\n
4. The abdominal cavity is then entered and the vesicouterine fold is identified (fold of tissue between the bladder and uterus).<\/p>\n
5. A No. 10 scalpel is used to make a superficial incision in the vesicouterine fold.<\/p>\n
6. The bladder is retracted caudally (toward the feet) with a Deaver retractor.<\/p>\n
7. A transverse (side to side) incision is made in the anterior uterine wall with return of amniotic fluid.<\/p>\n
8. The incision is extended sufficiently to permit two fingers to be inserted into the uterus.<\/p>\n
9. The uterus is then stretched transversely.<\/p>\n
10. The fetus is grasped (preferably by the legs) and delivered out of the uterus.<\/p>\n
11. The umbilical cord is then clamped with two Kelly clamp and incised (cut) with a scissors.<\/p>\n
12. The newborn’s mouth is them immediately suctioned and the infant is handed to the pediatrician or nurse.<\/p>\n
13. The placenta is then manually extracted from the uterus (the surgeon places their hand into the uterus and pulls\/pushes out the placenta). Some practitioners deliver the uterus out of the incision first before extracting the placenta.<\/p>\n
14. A large hand-held retractor (e.g., Deaver retractor) is then inserted into the opening of the uterus and the inside of the uterus is inspected for any retained placenta or bleeding or injury sites.<\/p>\n
15. The blood in and around the uterus is removed by suction.<\/p>\n
16.The uterus is then closed in two layers with the first layer using a continous suture with an absorbable 0 suture (e.g., Vicryl suture).<\/p>\n
17. The second layer of uterus is closed using an interrupted 0 suture.<\/p>\n
18. The serosa (the outermost layer) of the uterus and the vesicouterine fold are closed in one layer using a continous 3-0 absorbable suture (e.g., Vicryl suture).<\/p>\n
19. The parietal peritoneum (anterior leaf of peritoneum) is closed using a running 3-0 absorbably suture (e.g., Vicryl suture).<\/p>\n
20. The rectum muscle sheaths are reapproximated in the midline and the muscle fascia is closed using either a continous or interrupted suture (both permanent and absorbable sutures are used).<\/p>\n
21. The superficial layers are closed in 1 or 2 layers – if there is a well-developed layer of Scarpa’s fascia this is closed using a 3-0 Vicry suture in an interrupted fashion.<\/p>\n
22. The skin is closed with staples or sutures.<\/p>\n
23. During closure it is customary to irrigate the wounds before each layer is reapproximated with saline solution.
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Surgical Details of Procedure 1. A transverse (side to side) skin incision is made at the level of the pubic bone with a No. 10 scalpel. A midline incision can also be used. 2. Bovie cautery is used to dissect through the subcutaneous tissue to the bilateral rectus muscles. 3. The rectus muscles and the […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[46],"tags":[],"yoast_head":"\n