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Standards for Female and Male Sterilization Services - STATE ...

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60<strong>St<strong>and</strong>ards</strong> <strong>for</strong> female <strong>and</strong> male <strong>Sterilization</strong> services8. Surgical approach<strong>Male</strong> sterilizationLocal anaesthesiaTechniqueType of incisionConventionalNSVMaterial <strong>for</strong> occlusion of vasFascial interpositionLength of vas resectedSuture of silk <strong>for</strong> conventional vasectomyLignocaine 2%.........................................................................................ccOther............................................................................................................Conventional........................................ NSV............................................Single vertical................................. Double vertical................................Single puncture...........................................................................................2–0 Silk.......................................... 20 Catgut..........................................Yes.................................................... No....................................................If no, give reasons......................................................................................................................................................................................................................................................................................................................................................................................................................................................cmSilk.................................................. Other...................................................Surgical notes ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................Any other surgery done at time ofsterilization?Specify details of complications <strong>and</strong>managementYes................................................... No.....................................................If yes, give details..........................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................Name <strong>and</strong> signature of the operating surgeonDate

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