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PubMed1979

[Regeneration of the Fallopian tubes following sterilization (author's transl)].

After any trauma to the fallopian tubes by a sterilizing operation, pregnancy occurs. If the sterilizing procedure was by high frequency current coagulation, large areas of the fallopian tube must be destroyed down into the mesosalpinx in order to avoid the preprogrammed recanalization tendency of the muellerian duct. Fertilization has occurred in recanalized fallopian tubes which only showed a cubic epithelium. Extensive destruction of the fallopian tube is today not justifiable because of the possibility of interference with the ovarian blood supply and subsequent hormonal damage. At present the safest method of female sterilization is by tissue coagulation of segment of the fallopian tube at 100 centigrade and division of the coagulated portion. In 1000 cases there were no pregnancies.

Electrocoagulation↗
PubMed1979

[Ten years experience with laparoscopy in the state women's clinic of Nurenberg].

During the period from 1968--1977 2400 laparoscopies were performed. Of these 10.7% were for diagnostic purposes only, in 3.6% of the cases laparoscopy was combined with biopsie and in 85.7% with tubal sterilization. Deaths or serious bleedings did not occur, laparotomies were not necessary. Total insignificant complications amounted to 1.6% (1.3% small bleedings which did not necessitate an operation and in 0.3% clinical signs of peritonitis, these disappeared after 3 to 15 days). In 0.7% laparoscopy was interrupted because of poor vision. Nine of 2055 women became pregnant after sterilization (4.5 pregnancies/1000 sterilizations). In 2 cases the ligamentum rotundum was coagulated, in 7 cases recanalization was histologically confirmed. Until Oct. 1975 coagulation was unipolar, afterwords bipolar. In 45.3% the patients had undergone an operation before, like Ceasarian section, gallbladder operation, appendectomy or umbilical hernia operation. Patients with longitudinal incision, with preceding peritonitis or ileus were excluded from laparoscopy. Laparoscopy was performed by all assistents during their last year of clinical instruction. Their first 30 laparoscopies were done under control, every assistent performed about 100 laparoscopies.

Female↗
PubMed1979

Silicone band sterilization with radiographic and laparoscopic evaluation.

Laparoscopic tubal sterilization, using a Silastic band to occlude the tubal lumen, was performed on 224 patients. The incidence of complications was low and only 2 pregnancies occurred. Further evaluation by hysterosalpingography on 97 patients revealed 2 distinct images. The site of tubal occlusion was seen on laparoscopy performed on 7 patients. The radiographic and laparoscopic findings are discussed.

Adult↗
PubMed1979

[Laparoscopic sterilization with electrocautery: complications and reliability (author's transl)].

1084 laparoscopic sterilizations were evaluated in a retrospective study at the Universitäts-Frauenklinik Zürich. The operative and early postoperative complications and the reliability of the method were analysed and compared to the results in the literature. Based on a cumulative statistical analysis 0,5% intraoperative complications required laparotomy, the main indications being haemorrhages and bowel injuries. Failed attempts were encountered in one of 150 patients, the main causes of which were adhaesions and difficulties at establishing pneumoperitoneum. The failure rate of the laparoscopic electrocoagulation of the fallopian tube after a long-term follow-up was about 0,5%, 20--25% of these were ectopic pregnancies. The transection of the fallopian tubes did not diminish the pregnancy rate, but the risk of bleeding was considerably higher with this technic. Concurrently performed therapeutic abortion or preceeeding laparotomy did not increase the operative complication rate.

Electrocoagulation↗
PubMed1979

Laparoscopic tubal sterilization using thermal coagulation.

A technique using a low-voltage, rechargeable battery pack and a cautery hook assembly for thermal coagulation and division of the fallopian tube under laparoscopic visualization has been evaluated in 393 patients. The procedure is quick, easy to perform, and electrically safe. The gross extent of the burn to the fallopian tube by thermal coagulation and division was compared with that done by high-frequency unipolar electrocoagulation and division. The difference in the mean total gross tubal burn produced by the 2 methods is not statistically significant. The variance of total tubal burn in individual cases within each group is significantly greater in the electrocoagulation group. The authors assume that pregnancy rates in patients undergoing thermal coagulation and division will be no different than those reported in patients in the electrocoagulation and division group. Two hundred of the patients have been followed from 12 to 33 months and no method-failure pregnancies have occurred.

Electrocoagulation↗