|
pubmed:otherAbstract |
PIP: The tubal ring was described in 1972, and in 1974 Yoon applied it in a multicentric trial. The ring consists of silicone rubber impregnated with 5% barium sulfate. Since 1986 a total of 103 laparoscopic sterilizations were performed in women over 35 in accordance with legal stipulations. The operation was done under endotracheal anesthesia. 1 1/min carbon dioxide was insufflated, usually 3-5 liters, via a needle umbilically under control of intraabdominal pressure. The uterus was manipulated transvaginally by means of a vacuum portio adapter. The laparoscope was also introduced umbilically and under laparoscopic control the ring applicator suprapubically medially. The ring was fixed onto the isthmic portion of the tube 2-3 cm from the uterus. The pierced wound was closed with a metal clasp. The operation lasted 15-30 minutes. The patients received routine analgesics, antiprostaglandins, rectally or im, then according to need. Hospitalization lasted 4-5 days. There were 7 complications ascribed to technique: in 2 instances pneumoperitoneum made the operation difficult, in 2 cases the ring was lost in the abdomen, and in 3 cases the slipped ring was successfully removed. There were 3 surgical complications: 2 instances of cutting the tube necessitating laparotomy in 1 case, and in the other the ring was attached to the cut end of the tube. In 1 case a hematoma of 2-3 cm size formed under the ring at mesosalpinx that did not require surgical intervention. 1 woman with a perigenital wound healing was subfebrile for a few days after the operation, and another woman became pregnant a few months after sterilization. 1 woman underwent sterilization while pregnant and abortion was performed later. Another woman underwent simultaneous abortion and sterilization following 2 cesarean sections. Pregnancy (sometimes extrauterine) occurs in .1-1.5% after this simple, safe, long-lasting procedure, mainly in the 1st year.
|
