ABSTRACT
PIP: A pilot research study was conducted at the Chiang Mai Christian Clinic of the McCormick Hospital's Family Planning Program in northern Thailand from August 1976-78. 450 cases of minilap performed by 2 surgical-theatre nurses were compared to 450 cases performed by a physician-surgeon, working with the same socioeconomic class of patients, in the same location, under the same circumstances. The training course for operating-theater nurse-surgeons took 3 steps: 1) long experience as an operating theater nurse in general surgery, followed by long experience in assisting minilaps; 2) 2-week intensive training in which nurse performs approximately 15 minilaps with physician assisting; and, 3) performance of minilap by the nurse as first surgeon. To date, each of the 2 theater nurse-surgeons has performed about 225 minilap sterilizations as first surgeon. Hematomas of the wound occurred largely in the early experience of the nurse surgeons. Perforation of the uterus with the uterine elevator occurred in 3 physician-surgeon cases, 1 in the nurse-surgeon cases. This is attributed to the more difficult cases assigned to the physician-surgeons. In the physician-surgeon group there was 1 case of urinary bladder injury, due to a previous Caesarean section with extensive adhesions. All operations were performed on an outpatient basis under local anaesthesia after premedication with diazapam and atropine.^ieng
