How is extraperitoneal cesarean section performed?

Extraperitoneal cesarean section is a type of cesarean delivery. First, the skin and subcutaneous fat layer are incised, followed by separation of the peritoneum and lower uterine segment. If skin suturing is required, a vertical incision is made beneath the skin. This procedure should be performed at a正规 hospital under the guidance of a qualified physician. The specific steps are as follows:

1. Anesthesia

General anesthesia or neuraxial anesthesia (such as spinal or epidural) may be selected, with intermittent general anesthesia using 5-0 absorbable sutures.

2. Incision

A transverse mid-abdominal incision or a vertical incision in the right lower quadrant along the midline is chosen; the length depends on abdominal wall thickness and estimated surgical duration. Standard skin disinfection and draping are performed. After skin incision, the abdominal cavity and bladder are exposed. Intermittent general anesthesia with 6-0 absorbable suture is administered below the left xiphoid process.

3. Surgical Procedure

1. First, remove the anterior or posterior wall of the uterus. When making a transverse uterine incision, minimize residual myometrial tissue to reduce bleeding.

2. Bladder posterior wall dissection: After opening the submucosal muscular layer of the posterior bladder wall, first transect the vessels of the left lower uterine segment anterior sheath and the round ligament of the uterus. Then, from the extraperitoneal fat on the left side, detach the upper portion of the bladder, and on the right side of the bladder, transect the vessels of the lower segment anterior sheath and the round ligament of the uterus.

3. Gastric mobilization: If the stomach cannot be preserved, make every effort to extend the upper margin of the stomach downward.