Laparoscopic sterilization with spring-loaded clips: double-puncture technique

Abstract

The application of a spring-loaded clip to each fallopian tube using a second-incision clip applicator is a safe and effective method of laparoscopic sterilization. The operation is quick and easy to perform and is suitable for use with local anesthesia. The method avoids the dangers of hemorrhage, for the clip only alters 3 mm of the fallopian tube and does not transect the tube or mesosalpinx. No pregnancies have followed the sterilization procedure. An intrauterine pregnancy has occurred after a reversal procedure in one patient.

PIP: 533 women undergoing laparoscopic sterilization were studied in an effort to determine the feasibility and safety of a second-puncture clip applicator. The operation was done on an outpatient or overnight basis and a choice of general or local anesthesia was offered. Results indicated that 97.7% of the cases were uncomplicated while 1.2% resulted in bowel perforation; .4% in hematoma and .7% in tubal ligation. None of the complications were due to clip or applicator design. 85% of the cases had no complaints while 5% of the patients experienced abdominal discomfort lasting 48 to 72 hours. This was the only side effect related to the procedure with a spring-loaded clip. No pregnancies occurred at the 6-month follow-up and 1 reanastomosis occurred supporting existing evidence about successful reversal after sterilization with a spring-loaded clip.