A rapid inexpensive and effective method of surgical sterilization by laparoscopy.

Abstract

25 patients (aged 21-38) were surgically sterilized by electrocauterization and excision of a portion of each fallopian tube in a study at Johns Hopkins Hospital. The operation is referred to as laparoscopy bilateral partial salpingectomy through the fiber optic laparoscope (BPS). The procedure was the method of Steptoe. Each tube was cauterized until it blanched for 3 cm along the tube and 1-2 cm into the mesosalpinx. A 5 mm segment was pulled through the biopsy forcep shaft and excised. Excision sites were observed for hemorrhage for 4 minutes. If hemorrhage occurred the site was grasped with forceps and coagulated. Patients were kept overnight at the surgeons discretion. Average operative time was 35 minutes. Average hospital stay was 28 hours(unreliable patients had spent the night before the operation). Average cost was $125. In 1 patient a tubo-ovarian abscess was noted 4 weeks postsurgery. Bilateral tubal obstruction was found in 18 of 21 patients for whom hysterosalpingograms were performed (4 to 12 weeks postsurgery). Fulguration plus excision in sterilization should reduce the failure rate of fulguration alone.