How is postpartum tubal sterilization performed using the Parkland method?

Updated: Jun 18, 2018
  • Author: Nan G O'Connell, MD; Chief Editor: Christine Isaacs, MD  more...
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Answer

Answer

Parkland method

In some circumstances, tubal occlusion by the Parkland method may be appropriate, usually when there is excessive tension on the loop of tube that makes it more likely that the cut ends would slip out of the suture once excised.

The fallopian tube is identified and grasped in the mid-isthmic portion as above. An incision is made in an avascular window of the mesosalpinx below the tube with Bovie cautery or Metzenbaum scissors. A 1-2 cm portion of tube is then ligated proximately and distally with chromic suture, and the tubal portion is excised with Metzenbaum scissors. Again, one suture should be held long until hemostasis is assured and the tubal ostia identified.


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