Abstract

PIP: The problems which may arise in the course of laparoscopic sterilization are discussed. The overall mortality rate from laparoscopic procedures has been put at 20-30 per 100,000 procedures. Previous abdominal surgery is no longer regarded as an absolute contraindication, and extremely obese patients can now be operated upon with modified instruments. The reported morbidity for the procedure has ranged from 1%-6%. The most common major complications are emphysema, cardiac and respiratory difficulties, organ perforation, burns, and hemorrhage. Techniques for avoiding these complications are described. The overall failure (pregnancy) rate for the procedure has ranged from 0%-2%. Causes for failure and surgical techniques to assure complete sterilization are given. It is now considered safe to perform laparoscopic sterilization in the early postpartum period, though procedures for introducing a pneumoperitoneum and the tubal site for coagulation must be slightly modified. Bleeding and hypotension are the most frequent complications in postpartum patients. Laparoscopic sterilization in conjunction with abortion is being more commonly performed. The average hospital stay for postabortion sterilization patients without complications is 2.4 days. Outpatient cases have been reported where the shortest stay was 9 hours.