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CENTRE OF EXCELLENCE IN STERILIZATION & RECANALIZATION

GOVT. KILPAUK MEDICAL COLLEGE HOSPITAL

KILPAUK, CHENNAI-600010

DR.A.KALAICHELVI., MD., DGO., DNB., Professor of obstetrics & gynaecology and programme director for centre of excellence (CEO) microsurgery department having 26 years of teaching experience.

She has been an Assistant Professor in the department of Microsurgery for more than 16 years and conducted many workshops in microsurgery and now joined as Professor in the same department. A detailed report on microsurgery department is given below.

She has been the Trainer for the Training course in Female recanalisation for the core officers of the centre of Excellence of India.

During the late 80s, the Govt . of India (GOI) and Govt of Tamil Nadu (GOTN) realised the need to provide a centre for tubal recanalisation to those women and men who had undergone sterilization and who subsequently regret the decision either due to loss of a child or other social and demographic reasons. Hence with the help and liberal aid from the Association for Voluntary Surgical Contraception (AVSC), USA AND THE UN agency UNFPA (United Nations Fund For Population Activities) 4 regional & 12 subcentres of COEs were started in India . they are :

Kilpauk Medical College and Hospital, Chennai
Maulana Azad Medical College, New Delhi
R.G.KHER Medical College , Kolkatta and
G.S.Seth Medical College , Mumbai

The MOU signed at that time was for continuing the COE under GOI and UNFPA and later to be taken over by GOTN . The area of coverage for the kilpauk Medical College included apart from the southern states the Andamans also.

The Centre of Excellence (COE) , Microsurgical Unit was declared opened on 24th June 1987 by the then Hon. Minister of Health and Family Welfare, vide G.O.1112/Health dt.16.6.1987. This was functioning as a service and training centre for microsurgical recanalisation under the auspices of Govt. of Tamilnadu, GOI, UNFPA and AVSC.

The Kilpauk Medical college centre is unique in that it has an exclusive laboratory, for training programmes in microsurgical recanalisation, operation theatre, ward and an auditorium in the first floor.

The first director of the COE was none other that Prof .Padmashree Dr.B. Palaniappan . MS, FRCS who was also invited by the AVSC to Koea to enlighten the COE activities in India in its first International meet.

After the first Director, Prof.B.Palaniappan, Prof.T.K.Mohanalakshmi became the next Director of Coe. The department was subsequently headed by many gynaecologists.

Prof.A.Rajasekaran, was the first Male Core Officer and he was succeeded by other professors of Urology.

The centre had conducted 37 workshops on standards of sterilization for male and female.

In collaboration with OGSSI , COE is conducting Recanalisation workshops periodically.

The centre was recognised as Apex Centre to conduct training programmes for core officers of other 15 COEs in 2005. Since then microsurgery core officer training programmes were conducted each for 15 days.

The trainees were from all over India(Delhi, Calcutta, Cuttack, Lucknow, Amritsar, Rohtak, Hubli, Hyderabad, Patna).Recently in January and February,2011 we have conducted training programmes in female recanalisation for the core officers of Centre of Excellence of India.

At present COE caters to poor women seeking reversal of sterilisation and infertile women with tubal block . there is a steady demand for microsurgical recanalisation due to unfortunate loss of the child subsequent to sterilisation and in infertile women. The incidence of infertility attending op, is around 15%.Tubal recanalisation was performed for women in dire need as in cases of natural calamity like Tsunami and tragedy like Kumbakonam fire accident . The need for reversal of sterilisation will be present till the neonatal and infant mortality is brought to zero.

SCHEDULE FOR TRAINING PROGRAMME IN MICROSURGERY(10 DAYS)

Day Time Class
Day 1 9-10am
10-11AM
11-12PM
1-2PM
2-4PM
INTRODUCTION OF COE
LECTURE ON OPERATING MICROSCOPE
MICROLAB -GLOVE BOARD SUTURING TECHNIQUES
LUNCH
INSTRUMENTATION &GLOVE BOARD SUTURING
Day 2 9-10am
10-1PM
1-2PM
2-4PM
MICROLAB-GLOVE BOARD SUTURING
OPERATING THEATRE-ASSISTING SURGERY
LUNCH
MICROLAB –GLOVE BOARD SUTURING
Day 3 9-10am
10-1 PM
1-2 PM
2-4 PM
LECTURE ON TUBAL MICROSURGERY IN INFERTILITY
MICROLAB -TUBECTOMY SPECIMEN
LUNCH
MICROLAB –TUBECTOMY SPECIMEN
Day 4 9-10am
10-1 PM
1-2 PM
2-4 PM
MICROLAB –GLOVE BOARD SUTURING
O.T -ASSISTING SURGERY
LUNCH
MICROLAB
Day 5 9-10am
10-11AM
11-1 PM
1-2 PM
2-4 PM
LECTURE ON TUBAL REANASTOMOSIS
MICROLAB-RAT UTERINNE HORN DEMONSTRATION
RAT UTERINE HORN-HANDS ON TRAINING
LUNCH
MICROLAB-RAT UTERINE HORN
Day 6 9-10am
10-1 PM
1-2 PM
2-4 PM
LECTURE ON TUBAL MICROSURGERY IN INFERTILITY
MICROLAB -TUBECTOMY SPECIMEN
LUNCH
MICROLAB –TUBECTOMY SPECIMEN
Day 7 Sunday
Day 8 9-1 PM
1-2 PM
2-4 PM
MICROLAB-GLOVE BOARD ,TUBECTOMY SPECIMEN, UMBLICAL CORD –HANDS ON
LUNCH
RAT FEMORAL ARTERY –DEMONSTRATION
Day 9 9-10am
10-1 PM
1-2 PM
2-4 PM
MICROLAB
O.T.ASSISTING.
LUNCH
MICROLAB
Day 10 9-10am
10-1 PM
1-2 PM
2-4 PM
POST TRAINING EVALUTION
MICROLAB
LUNCH
VALEDICTORY FUNCTION.

HANDS ON TRAINING IN MICROSURGICAL PROCEDURE IN RAT UTERINE HORN


ANAESTHETISED RAT UTERINE HORN IDENTIFIED
 
SHOWING BOTH UTERINE HORNS TRANSECTED UTERINE HORN
 
BOTH ENDS OF TRANSECTED
UTERINE HORN
SUTURING THE MUSCULARIS
AT 6’O CLOCK POSITION OF ONE END
 
SUTURING THE OTHER END
OF THE HORN
APPROXIMATING BOTH THE
ENDS- END TO END ANASTAMOSIS
 
APPROXIMATION OF THE SEROSAL LAYER RAT FEMORAL ARTERY- VASCULAR ANASTAMOSIS
ENDS- END TO END ANASTAMOSIS
 
APPLICATION OF VASCULAR CLAMPS
OF THE HORN
MICROSURGICAL TUBAL RE-ANASTAMOSIS
 
STERILISATION SITE STATUS OF TUBE- PROXIMAL
AND DISTAL SEGMENT
 
PATENCY OF PROXIMAL
AND DISTAL SEGMENTS OF TUBE
BEFORE RECANALISATION
 
AFTER RECANALISATION
 
 
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