A Comparative Study of Electrocoagulation and Tubal Rings for Tubal Occlusion at Laparoscopy

Abstract

The surgical and early postoperative complications and complaints associated with laparoscopic sterilization using electrocoagulation or tubal rings for tubal occlusion were evaluated in a comparative study. Procedures were randomly assigned to subjects (electrocoagulation to 151 subjects and tubal rings to 148 subjects). Difficulties in carrying out the sterillization procedures occurred more frequently when tubal rings were used (6.1%) than when electrocoagulation was used (2.0%). Rates of complications occurring at the time of surgery were similar for the two procedures. However, one patient in the electrocoagulation group had a bowel burn. Postoperative pelvic and abdominal pain were reported by a significantly higher proportion of the tubal ring cases (32.0%) than electrocoagulation cases (19.4%). It appears that although the incidence of surgical difficulties and pain may be somewhat more frequent with the tubal ring, the avoidance of such potentially serious complications as bowel burns may make femal sterilization by the tubal ring method preferable.

Techniques for the interruption of tubal patency for female sterilisation

“…• Sterilisation (interval) with partial salpingectomy (modified Pomeroy technique) compared with electrocoagulation: three trials, including 2019 women (Siegle 2005;Sitompul 1984;WHO 1982). • Sterilisation (interval) using tubal ring compared with electrocoagulation: two trials, including a total of 599 women (Aranda 1976;Koetsawang 1978). Electrocoagulation was specified as unipolar in Koetsawang 1978, and bipolar in Gentile 2006, Goynumer 2009and Siegle 2005, but type was not specified in three other trials that used electrocoagulation.…”

“…Access to the abdomen was achieved by di erent approaches. Ten studies used laparoscopy (Aranda 1976;Argueta 1980;Geirsson 1985;Gentile 2006;Goynumer 2009;Koetsawang 1978;Pymar 2004;Siegle 2005;Stovall 1991;Toplis 1988); three used laparotomy (Aranda 1985;Qui 2011;Yan 1990); two used minilaparotomy (Kohaut 2004; Rodriguez 2013); three used minilaparotomy or laparoscopy WHO 1982), and one study compared three di erent approaches to enter the abdominal cavity (Sitompul 1984).…”

“…The type of anaesthesia used varied among participating institutions according to institutional standards or at the surgeons' discretion for certain multicentre studies (Rodriguez 2013;WHO 1982). For other studies, procedures were performed under general anaesthesia (Geirsson 1985;Goynumer 2009;Siegle 2005), local anaesthesia (Aranda 1976;Argueta 1980;Koetsawang 1978;Qui 2011;Sitompul 1984) epidural anaesthesia (Yan 1990), general or local (Aranda 1985), general or spinal (Kohaut 2004), or was not clearly stated Gentile 2006;Pymar 2004;Stovall 1991;Toplis 1988).…”

Laparoscopic Sterilization with Spring‐Loaded Clip and Tubal Ring in Postabortal Cases—One‐Year Follow‐up

“…In a similar comparative study of laparoscopic electrocoagulation versus tubal ring, the rate of surgical difficulty was significantly higher (p < 0.01) with the tubal ring (6.1%) than with electrocoagulation (2.0%), and this is probably attributable to improper visualization of the tubes because of the decreased field when using the ring applicator (1). When the electrocoagulation and spring-loaded clip techniques were similarly compared, surgical difficulties were significantly higher (p < 0.01) for the latter (6.0%) than the former (2.0%).…”

Advances in Sterilization Equipment

“…Only in the past decade has female sterilization technology advanced to the point where it can routinely be performed as an outpatient procedure. The principles of laparoscopy were first applied to sterilization in the early 1960s (71), and since then laparoscopic sterilization has become an important component of family planning programs in many parts of the world, including Latin America (1,33,45,53).…”