Laparoscopic sterilization: experience with the Falope-RingTM
Pulliam, R.P.
West Virginia Medical Journal 74(3): 49-52
1978
ISSN/ISBN: 0043-3284 PMID: 146969 Document Number: 138688
Most of the complications associated with laparoscopic sterilization can be minimized by proper patient selection, optimal equipment, conditions, training and experience. While most of these complications (physioperitoneum, electrical, bleeding, penetration, infections and pregnancy) are limited to, but not necessarily inherent in laparoscopic sterilization, electrical burns are almost exclusively technique-related (Loffer, Pent). The Falope-Ring sterilization eliminates electrical complications (it does not use electrical current) as documented in this study. 639 patients were sterilized at the Raleigh General Hospital (February 1975-January 1977) using Falope-Ring technique and were followed up for 7459 women-months. Despite careful patient screening, two luteal phase pregnancies were observed at the time of surgery. Tears in the mesosalpinx occurred in the 1st 3 months and were controlled using standard Pomeroy ligations; 4 cases of bleeding from puncture sites were managed using sutures under direct laparoscopic visual control. One patient had bizarre pelvic radiolucences ("Cheerios" in the pelvis) upon x-ray presentation. Other studies have documented postoperative pain on the basis of tissue strangulation (this did not occur in this case possibly due to exclusive use of general anesthesia); postprocedure ectopic pregnancies (Brenner and Mishell), which were not observed in this study; and tubo-peritoneal fistula following Falope-Ring ligation (Yoon, King and Parmley). Overall, Falope-Ring sterilization is a safe and effective technique. Luteal phase pregnancies could be avoided by immediately performing the procedure postmenstrually in all patients except those on oral pills.