Minilaparotomy or laparoscopy for sterilization: a multicenter, multinational randomized study. World Health Organization, Task Force on Female Sterilization, Special Programme of Research, Development and Research Training in Human Reproduction

Abstract

A multicenter, multinational randomized comparison of minilaparotomy and modified Pomeroy tubal ligation and laparoscopy with tubal electrocoagulation for interval sterilization of women was conducted in eight centers. Results were analyzed for 791 women in the minilaparotomy group and 819 in the laparoscopy group. Major complications occurred in 1.5% of women in the former group and 0.9% in the latter. Technical problems or major anesthetic complications occurred in 0.5% of subjects undergoing minilaparotomy and 0.9% of subjects undergoing laparoscopy. For minor complications the figures were 11.6% and 6.0%, respectively, while for minor complaints the rates were 34.1% and 26.5%, respectively. It is concluded that the two methods of approach to the fallopian tubes are similar in their complication rates. Because of its more simple requirements in terms of equipment and training, minilaparotomy is the preferred approach for services provided away from a major institution.

PIP: A multicenter, multinational randomized comparison of minilaparotomy and modified Pomeroy tubal ligation and laparoscopy with tubal electrocoagulation for interval sterilization of women was conducted in 8 centers (Bangkok, Havana, London, Los Angeles, Santiago, Seoul, Singapore, and Sydney). Results were analyzed for 791 women in the minilaparotomy group and 819 in the laparoscopy group. Major complications occurred in 1.5% of women in the minilaparotomy group and 0.9% in the laparoscopy group. The most serious complications were injury to other organs and excessive bleeding. Technical problems or major anesthetic complications occurred in 0.5% of subjects undergoing minilaparotomy and 0.9% of subjects undergoing laparoscopy. Minilaparotomy was associated with more minor complications (11.6%) and complaints (34.1%) than laparoscopy (6% and 26.5%). This study has demonstrated small but clinically manageable differences between the 2 methods. Because of its more simple requirements in terms of equipment and training, minilaparotomy is the preferred approach for services provided away from a major institution.