Bilateral salpingectomy, laparoscopic

• positioned in lithotomy position
• It is recommended to position both arms alongside the body (caution: use cotton wrapping when positioning with a cloth sling), or position one arm on the assistant's side
• The legs should be adjustable via the operating table controls during the procedure
• if necessary, use shoulder supports to prevent the patient from sliding on the operating table
• if necessary, attach a cervical adapter

Creation of a pneumoperitoneum by inserting a Veress needle, usually infraumbilically. Insertion with the optical trocar infraumbilically.

During laparoscopy, the inspection of the abdomen is performed, including the upper abdominal area, the diaphragmatic domes, the liver, the gallbladder, the stomach, and the omentum. Additionally, an inspection of the intestines and the peritoneum is conducted.

Placement of 2 additional 5 mm working trocars under direct vision.

The selection of the number and position of laparoscopic incisions is at the discretion of the surgeon and is based on their personal preferences as well as the specific requirements of the operation. Incisions are often chosen in the left and right lower abdomen or in the left lower and mid-abdomen (left periumbilical).

Procedure for incisions in the lower abdomen: Visualization of the inferior epigastric artery in the lateral umbilical fold. Lateral to this, the superficial vessels are visualized through diaphanoscopy (superficial circumflex iliac artery, superficial epigastric artery). Two transverse fingers medial to the anterior superior iliac spine, in the vessel-free area, incision and insertion of a working trocar into the lower abdomen.

Procedure for incisions in the mid-abdomen (mostly left): Visualization of the inferior epigastric artery in the lateral umbilical fold. The superficial vessels are visualized through diaphanoscopy. Incision at the level of the navel and approximately 3 cm lateral to it. It is important to ensure that the incision is not too close to the optical trocar or in line with the working trocar of the lower abdomen, to avoid collision risk.

Procedure for suprapubic incisions: Preoperative placement of a urinary catheter to empty the bladder. 1-2 transverse fingers above the symphysis, the superficial vessels are visualized through diaphanoscopy. Incision and insertion of the working trocar under direct vision.

Inspection of the pelvis, considering the uterus, both adnexa, the Douglas pouch, and the transperitoneal visualization of both ureters.