Laparoscopic sterilization. American Association of Gynecologic Laparoscopists 1991 membership survey

Abstract

The 1991 membership survey of the American Association of Gynecologic Laparoscopists indicated more laparoscopic procedures than had been reported in the last survey, in 1988. The respondents reported 30,480 sterilizations, 41,160 diagnostic laparoscopies and 8,015 hysteroscopies. The distribution of sterilization by method of tubal occlusion has remained stable since 1985. Complications from diagnostic laparoscopy remain consistently higher than from sterilization. This year the complication rate for diagnostic procedures was higher than in any other year since 1976 (4.9 per 1,000 cases). One death was reported after sterilization and one after diagnostic laparoscopy.

PIP: 1314 members of the American Association of Gynecologic Laparoscopists responded to a survey enumerating numbers and types of laparoscopic procedures performed in 1991. The survey is conducted every 3 years. Members reported 40,337 laparoscopic sterilizations, 66,887 diagnostic laparoscopies, and 8015 hysteroscopies. This is an increase in both types of laparoscopies compared with 1988. Most of the sterilizations were done by bipolar coagulation. The types of sterilization methods remained similar to those used in previous years. 79% used a closed abdominal approach. 78% always used general anesthesia, while 1% always used local anesthesia. The complication rate for diagnostic laparoscopy was 4.9/1000 up from 3.1% found in the last 2 surveys. The rate of ectopic pregnancy among sterilization failures was 66% for bipolar and 68% for unipolar coagulation, somewhat higher than that found for Pomeroy, band, and especially the clip method. 2 deaths were reported, 1 for sterilization and 1 for diagnostic laparoscopy. Although these data are not randomized, the consistency of the questions and the sampling base make them worthwhile.