[The effectiveness of different methods of laparoscopic tubal sterilization (author's transl)]

Abstract

If sterilization is offered today to a young multipara pointing out the possibility of eventual later recanalization the most essential point lies in thorough patient information. The patient must be informed that less aggressive techniques like thermocoagulation or mechanical tubal occlusion bear a higher risk of failure and consequently eventual pregnancy 2%-4%-7%. Such failures are part of the method and must and cannot be considered malpractice. Extensive patient information about all pros and cons is the only way to avoid future problems. Spontaneous tubal recanalization has occurred and may occur to the most skilled surgeon. After twenty years of personal experience with almost all methods of laparoscopic tubal sterilization my recommendation today is: bipolar sterilization on one site of the isthmical tubal portion with division of the coagulated tissue. Even so sufficient tubal tissue should remain intact to allow eventual later recanalization. We were never disappointed with this way of proceeding and so far, contrary to all other methods, have observed no pregnancy among our patients.

PIP: If sterilization is offered to a young multipara today with the possibility of eventual recanalization, most essential is thorough patient information. The patient must be informed that less aggressive techniques such as thermocoagulation or mechanical tubal occlusion carry a higher risk of failure and subsequent pregnancy, 2%-4%-7%. Such failures are part of the method and should not be considered malpractice. Extensive patient information about pros and cons is the only way to avoid future problems. Spontaneous tubal recanalization has occurred even with the most skilled surgeon. With 20 years of personal experience with almost all methods of laparoscopic tubal sterilization, the author recommends bipolar sterilization on 1 site of the isthmic tubal portion with division of the coagulated tissue. Even so, sufficient tubal tissue should remain intact to allow for eventual later recanalization. This method has never disappointed anyone, and thus far no pregnancy has been observed among our patients. (Author's modified)