A COMPARISON OF DIFFERENT LAPAROSCOPIC STERILIZATION OCCLUSION TECHNIQUES IN 24,439 PROCEDURES

The safety and efficacy of 5 laparoscopic tubal occlusion techniques for female sterilization were assessed: electrocoagulation, the tubal ring via conventional and open laparoscopy, the prototype spring-loaded clip and the Rocket clip. The 24,439 cases make up a data set collected by collaboration staffs at 64 institutions in 27 countries. The 5 techniques were compared with respect to 6 commonly evaluated parameters. Rates of surgical difficulties ranged from 2.4-12.5% (5.1% overall), rates of surgical complications from 0.7-2.7% (1.7% overall), and rates of technical failures from 0.6-1.0% (0.8% overall). Twelve-month life-table pregnancy rates were < 1 per 100 woman yr. Prospective data on 6 menstrual parameters revealed that the menstrual cycles of the majority of women were unchanged after sterilization; for those who reported a change, approximately 1/2 experienced a change in one direction and 1/2 in the other direction. For example, 1/2 reported an increase in the amount of menstrual flow, and 1/2 reported a decrease in the amount of flow. The reported incidence of subsequent pelvic operations was less than 1% at each long-term follow-up. Laparoscopic sterilization is safe and effective and none of the studied techniques has a distinct advantage.