Two randomized controlled trials comparing the Hulka and Filshie Clips for tubal sterilization

Sterilization

“…The Filshie clip was subsequently approved for use based on prospective trials demonstrating efficacy equal to that of other methods at 2 years (9.7 failures per 1000 procedures). 11 A second type of occlusive clip, the Hulka (Richard Wolf Medical Instruments Corporation, Vernon Hills, Illinois) clip, is a hinged spring clip that is placed over the isthmic portion of the tube. The spring-loaded clip is unpopular and rarely used because of its high failure rates (36.5 failures per 1000 procedures).…”

Design, Development and Validation of a Novel Mechanical Occlusion Device for Transcervical Sterilization

“…The Hulka clip was approved for use in the United States in the 1970's and was invented by Dr. Jaroslav Hulka at the University of North Carolina [53]. The Hulka clip is made of plastic and has toothed jaws as seen in Fig.…”

“…Filshie clip can be used on almost any fallopian tube, regardless of thickness or shape, including postpartum tubes. One of the advantages of the clip is that it only damages a very small portion around 4 mm of the fallopian tube [53,54,56,57,58,59]. Falope ring is also called the Yoon ring was first reported in 1974 [55].…”

Filshie clip closure: Determination of closure through the analysis of X-rays

“…The Filshie clip system has been used widely in Australia with great success. In Queensland alone, several thousand operations are done each year and the worldwide published statistics [1][2][3][4][5][6][7][8][9] indicate that a proportion of those operations will fail for reasons not attributed to the actions of the doctor. However, it is possible that some failures of the device may be due to incorrect fitting of the Filshie clips and this has led to a number of medical negligence cases against doctors.…”

“…The reported rates vary. Dominik et al 3 studied a population of 1036 women sterilized using Filshie clips and compared this population with 1062 women sterilized using Hulka clips and found that failure rates of approximately 1 per 1000 for Filshie clips could be expected assuming that the procedure was properly performed. This compared favorably to the Hulka clip where failure rates of approximately 7 per 1000 were observed.…”