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pubmed:abstractText |
Laparoscopic Falope-Ring sterilization was performed by residents on 71 women. Immediately following application of the ring, methylene blue was injected through the cervix to assess tubal patency. Unilateral spillage of the dye was demonstrated in four patients (5.6%). In these instances a new ring was applied, or the tube was tied surgically. The high rate of tubal patency was attributed to the surgeons' inexperience. The findings suggest that the use of a patency test as an adjunct to sterilization with the Falope-Ring in training programs is likely to decrease the rate of surgical failures.
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pubmed:otherAbstract |
PIP: Gynecologist residents in training performed 71 laparoscopic Falope-Ring sterilizations under supervision, and effectiveness of the ligation was tested by dye passage. The operations were done with the KLI one-puncture laparoscope under general anesthesia, and methylene blue dye was introduced transcervically via the Rubin cannula used to stabilize the uterus. Patients ranged from 23-49 years, mean 29.8, parity 1-8, mean 23.7. Dye spilled out on one side in 4 cases, all with a ring verified as placed on the fallopian tube. Two instances of slow dye passage occurred with the ring 1.5-2.0 cm from the uterotubal junction. In one case the ring encircled only the serosa of an edematous tube, and in the other the ring was too distant. The only other complications were loss of 2 rings in the peritoneal cavity, application of a ring on the round ligament, later corrected and a cervical laceration requiring suturing. Since others have also reported higher failure rates of band laparoscopic sterilization early in physicians' experience, it is recommended that doctors in training use the dye patency test.
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