Laparoscopic sterilization. Endocoagulation and bipolar electrocoagulation
Blaakaer, J.
Ugeskrift for Laeger 149(17): 1127-1130
1987
ISSN/ISBN: 0041-5782 PMID: 2954287 Document Number: 301105
This study compares the clinical results of 98 laparoscopic sterilizations performed upon patients randomly assigned to either bipolar electrocoagulation or endocoagulation (thermocoagulation). The electrocoagulation procedure used a Teflon-coated alligator clip heated to 120 degrees Celsius for 30 seconds. The tube was coagulated in two places in close proximity and clipped in the middle of the coagulated portion. The bipolar electrocoagulation used a 12 watt current to coagulate the tubes in two places without clipping. Both methods used infraumbilical puncture. None of the patients experienced serious difficulties such as damage to intraperitoneal organs. The average hospital stay for both groups was 2 days and there was no significant statistical difference between the time for return to normal level of activities, 6 days for both groups. There was no significant difference in report of postoperative complications. Although the study does not lead to a conclusive advantage for either of the 2 methods investigated, the authors believe that endocoagulation should be preferred as an alternative method of sterilization. The method is no more difficult than bipolar electrocoagulation and is safer than electrocoagulation in that tissue is not used as a conductor of electric current, which has led to reports of cases of perioperative lesions. Among 1500 sterilizations with endocoagulation, not a single pregnancy has been reported as a result of methodological problems. Compared to ring and clip techniques, endocoagulation has the advantage that difficulties cannot arise as a result of manufacturing errors in implanted materials.