The Titanium/Silicone Rubber Clip for Female Sterilization

Abstract

A composite titanium/silicone rubber clip has been developed for female sterilization. The 12.7 mm long metal clip is lined with silicone rubber and is bent round the Fallopian tube by means of an applicator that can be used laparoscopically. As tubal necrosis occurs, the rubber expands to keep the lumen blocked. The tube eventually divides and the stumps heal, closed. Since the Mark 3 version of the clip was introduced, over 5700 women in several countries have been sterilized. The first 540 British women who were followed-up for five to 17 months experienced one method failure (ectopic) and two operator failures, a total failure rate of 5 . 5 / 1000. Clip-related complications were minimal and long-term sequelae were comparable to tubal ligation. The clip causes minimal destruction but still seems effective for tubal occlusion and it can accommodate thick tubes.

Comparative efficacy of postpartum sterilisation with the titanium clip versus partial salpingectomy: a randomised controlled trial

“…Although the titanium clip was not available at the time of the study, the efficacy of the titanium clip has been well established. 5,6 However, with regard to postpartum use, data to support routine use of the clip are less clear. 3 Only eight postpartum women were included in the original efficacy trial, and their outcomes were not reported separately.…”

“…4 The use of occlusive devices, such as a ring or clip placed via laparoscopy, are commonly used methods for interval sterilisation (defined as tubal sterilisation at least 6 weeks following a birth), but have also been used in the postpartum period. 5 The use of an occlusive device, rather than transecting and ligating with suture, has the advantages of speed and ease of procedure.…”

“…6 Its use for sterilisation was first described in 1981 in a prospective cohort study of 540 British women. 5 Pregnancy outcomes and complications were assessed over 5-17 months. The titanium clip has a silicone lining that is applied to the isthmic region of the tube.…”

“…1 Partial salpingectomy with the modified Pomeroy or Parkland techniques are two common methods used in postpartum sterilisation. 5 Partial salpingectomy is a simple, safe procedure, where a segment of fallopian tube is ligated and removed bilaterally. 6 Partial salpingectomy can be more challenging in obese women, or in women with extensive intra-abdominal adhesions.…”

“…The titanium clip has a silicone lining that is applied to the isthmic region of the tube. 5 The clip is applied with a unique applicator, and must encompass the entire tube for effective compression. As necrosis ensues, the silicone lining maintains tubal collapse.…”