Laparoscopic Electrocoagulation and Tubal Ring Techniques for Sterilization: A Comparative Study

Abstract

From August 1975 through May 1976, a comparative study was made of the effects of sterilization by standard electrocoagulation and tubal ring application techniques. The two techniques were randomly assigned to 300 patients. Results show that standard electrocoagulation and tubal ring procedures can easily and safely be performed on an outpatient basis, using local anesthetics and analgesics. Rates of surgical complications for both techniques were clinically acceptable, although tubal risk patients had a higher rate. Pain during the procedure and during the immediate recovery period was more severe for tubal ring patients. Despite the higher incidence of surgical complications and pain associated with the ring, many physicians prefer this method of sterilization because it eliminates the possibility, inherent in electrocoagulation, of inadvertent serious electrical burns.

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).…”

“…Randomisation and allocation concealment was inadequately described in 50% of the studies. Blinding of the outcome assessor was described in nine studies (Aranda 1976;Aranda 1985;Argueta 1980;Gentile 2006;Koetsawang 1978;Pymar 2004;Rodriguez 2013;Yan 1990). Attrition bias was serious in two studies: in Geirsson 1985, nine women were excluded post-procedure "due to intra-operative di iculties" that were not described in detail, while in Aranda 1985, 30 cases of technical failure (5% of total) were excluded from the analyses.…”

Comparison of Laparoscopic Sterilization via Spring‐Loaded Clip and Tubal Ring

“…T h e severity of pain reported by patients during sterilization was significantly higher for the tubal ring procedures, although this difference did not continue during the recovery period or at early follow-up. T h e higher incidence of operative pain associated with the tubal ring has been reported in a similar study (2). It has been recommended that the ring and grasping forceps be passed through lidocaine jelly before insertion into the peritoneal cavity to avoid pain during the procedure.…”