Teaching laparoscopic sterilization.

Abstract

First-year obstetrics-and-gynecology residents participated in the attempted sterilization of 411 women by either Falope Ring application (FRA) or bipolar electrocoagulation (LTC). Ability to complete the procedure, as well as intraoperative and immediate postoperative complication rates, was reviewed. Characteristics that predisposed women to complications were assessed. Complications were more common in 165 women who underwent sterilization with FRA than in those who had LTC. Two FRA patients (0.9%) required laparotomy because of bleeding. In addition, failure to establish a pneumoperitoneum led to a minilaparotomy in one case. Nineteen FRA women (11.5%) experienced minor complications. The only major complications with the use of LTC were the need for minilaparotomy in two women in whom a pneumoperitoneum could not be established. Minor complications occurred in 4 of 227 LTC cases (1.8%). Current or past patient characteristics did not influence outcome except in the cases of failure to establish a pneumoperitoneum; those women were significantly heavier than others in this series. Limited experience in the instruction of FRA may have contributed to the higher complication rate and to the greater number of problems complicating sterilization with FRA as compared to LTC.