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At least 19 recordsLinked to original sources

Laparoscopic sterilization with the spring clip: instrumentation development and current clinical experience.

Since the original spring clip sterilization studies were reported, a number of clinically important modifications to the spring clip and applicator have been developed. The spring-loaded clip, manufactured by Richard Wolf Medical Instruments Corporation of Chicago, Illinois, and Rocket of London, Inc., London, England, and New York, New York can be applied with either a one- or two-incision applicator and the clips and applicators currently available incorporate improvements to the original prototypes in design, manufacture, and quality control. The two-incision applicator is associated with significantly fewer misapplications and the high pregnancy rates reported with the original clip and applicator have not occurred with the current designs. Comparative studies between the clip and band have revealed less operative bleeding and pain associated with the clip. The method is appropriate to all women requesting sterilization but especially to those in the younger age group who may subsequently request reversal because of divorce and remarriage.

Female

A comparison of the clip and ring techniques for laparoscopic sterilization of postabortion and postpartum patients.

The spring-loaded clip and the tubal ring techniques of laparoscopic female sterilization are compared for ease of performance, safety and effectiveness at the Kandang Kerbau Hospital in Singapore. The two techniques were randomly assigned to 299 postpartum patients and 300 postabortion patients. The assigned procedure could not be performed for two of the ring cases and three of the clip cases. Bleeding and equipment problems made laparotomy necessary in two clip cases and equipment problems caused a change in technique in the other clip case. Hydrosalpinx and adhesions were responsible for a change to laparotomy in the two ring cases. Surgical difficulties, chiefly the result of equipment problems, were significantly higher for both postpartum and postabortion clip procedures. Complications and complaints reported immediately after surgery and at the 7- to 21-day follow-up visit were low for all four groups. For both postabortion and postpartum patients, six- and 12-month data show that pregnancy rates are significantly higher for patients sterilized with the clip than with tubal rings.

Abortion, Induced

[Tubal sterilization with the tupla-clip per laparoscopiam (author's transl)].

This study refers about a newly developed plastic clip which has been used with good results for the past three years in tubal sterilization. By applying this method, heat or thermal injuries are avoided and a greater possibility of refertilization is indicated. This clinical evaluation consists of experimental data of 243 women who underwent sterilization in the local OB/GYN clinics at Fulda and at Bremerhaven. 59 women were sterilized during puerperium, and 184 were sterilized irrespective of pregnancy. As complications, 2 pregnancies were observed, further 3 hematomae within the broad ligament; 11 clips dropped into the free adbominal cavity while 5 clips broke during application. After the initial difficulties, the authors of this study recommend a sterilization with this tubal clip as an alternative to the usual methods of sterilization.

Adult

Sterilization by spring clip: a report of 1000 cases with a 6-month follow-up.

In September 1972, clinical trials of a spring-loaded clip for laparoscopic sterilization were begun and extended to a number of centers in the United States and overseas. As of March 1974, more than 1000 patients had undergone the procedure, usually performed under local anesthesia in an outpatient setting, with no fixed contraindications. Complications and pregnancy rates based on a preliminary 6-month follow-up are presented. Complications due to application of the clip appeared to be limited to postoperative cramps lasting 24 to 48 hours (26% of the patients). No ectopic pregnancies were reported. Pregnancies, when corrected for unsuspected pregnancies and misapplication of the clip, occurred in 2 of these first 1000 patients. The difficulties and relative contraindications learned from this unselected series and the advantages over electrocagulation techniques are discussed.

Abortion, Spontaneous

Spring clip tubal occlusion: a report of the first 400 cases.

Between September 1972 and March 1974, laparoscopic tubal sterilization was performed on 394 patients with the use of a spring-loaded plastic clip under local analgesia and on an outpatient basis. Intravenous fentanyl and infra-umbilical infiltration and tubal spray with 1% lidocaine were found to be very acceptable and effective forms of analgesia. The average time spent by a patient in the hospital was 4 hours, 26 minutes. There was no major immediate complications apart from vasovagal reactions in 34 patients. Up to June 30, 1974, six patients in the series had become pregnant, not as a failure of the clip per se, but as a result of improper application of the clips. This seems to be a safe, simple, and effective method of female sterilization with great potentials of reversibility.

Adult

A clip applicator for laparoscopic sterilization.

Laparoscopic sterilization using spring-loaded clips promises to reduce complications encountered with other sterilization techniques. A second-puncture clip applicator for laparoscopic sterilization has been developed which has several advantages over the single-puncture method, allowing a full visual field and more accurate placement of the clips. A description of the applicator, its assembly, operative procedure, and preliminary results are reported.

Female

Laparoscopic sterilization with spring-loaded clips: double-puncture technique.

The application of a spring-loaded clip to each fallopian tube using a second-incision clip applicator is a safe and effective method of laparoscopic sterilization. The operation is quick and easy to perform and is suitable for use with local anesthesia. The method avoids the dangers of hemorrhage, for the clip only alters 3 mm of the fallopian tube and does not transect the tube or mesosalpinx. No pregnancies have followed the sterilization procedure. An intrauterine pregnancy has occurred after a reversal procedure in one patient.

Abdomen

Mudskipper detects combinatorial RNA binding protein interactions in multiplexed CLIP data.

The uncovering of protein-RNA interactions enables a deeper understanding of RNA processing. Recent multiplexed crosslinking and immunoprecipitation (CLIP) technologies such as antibody-barcoded eCLIP (ABC) dramatically increase the throughput of mapping RNA binding protein (RBP) binding sites. However, multiplex CLIP datasets are multivariate, and each RBP suffers non-uniform signal-to-noise ratio. To address this, we developed Mudskipper, a versatile computational suite comprising two components: a Dirichlet multinomial mixture model to account for the multivariate nature of ABC datasets and a softmasking approach that identifies and removes non-specific protein-RNA interactions in RBPs with low signal-to-noise ratio. Mudskipper demonstrates superior precision and recall over existing tools on multiplex datasets and supports analysis of repetitive elements and small non-coding RNAs. Our findings unravel splicing outcomes and variant-associated disruptions, enabling higher-throughput investigations into diseases and regulation mediated by RBPs.

RNA-Binding Proteins

[Experience with the tupla-clip for tubal sterilization by laparoscopy (author's transl)].

For the last 18 months a plastic clip made of polyoxymethylene was used for tubal sterilization by laparoscopy. The clip was used in 140 cases. This report reviews 106 cases. One pregnancy occurred early in this series. There were no other complications. The advantages of the method are the short operating time and the elimination of intra-abdominal damage by heat. Reversibility of the method has not yet been assessed.

Adult

Spring clip sterilization: one-year follow-up of 1,079 cases.

This is a report of 1,079 patients who underwent laparoscopic clip sterlization as of March, 1974. A one-year follow-up was obtained on 977 patients, or 90.5 per cent. Complications due to the clip technique appear limited to postoperative cramps for 24 to 48 hours in 26 per cent of patients. No ectopic pregnancies were detected. Pregnancies, when corrected for unsuspected existing pregnancies and surgical and manufacturing errors, occurred in 2 to 6 cases, for a method failure rate of 2 to 6/1,000. This report documents that experienced laparoscopists can perform this practice with local anesthesia, in combination with first-trimester abortion, and in hospital facilities other than an operating room.

Anxiety

Incidence of pain among women undergoing laparoscopic sterilization by electrocoagulation, the spring-loaded clip, and the tubal ring.

Data analyzed from five comparative studies show a relationship between the technique of tubal occlusion and pain experienced by patients both at the time of the procedure and during the recovery period. During the procedure, the spring-loaded clip is the technique least likely and the tubal ring the technique most likely to be associated with pain. During the recovery period, both the spring-loaded clip and the tubal ring are associated with higher rates of abdominal or pelvic pain than is electrocoagulation. Differences in pain that occurred during the recovery period did not persist to the early follow-up visit.

Electrocoagulation

Early assessment of a tubal plastic (Bleier) clip.

Fifty patients have been sterilized laparoscopically using a plastic tubal (Bleier) clip having a "snap-shut" mechanism. Initial assessment indicates that the method is simple in principle but there are limitations, including the bulky dimensions of the applicator, absence of a safety-catch mechanism, and faults in the clip design. Modifications are indicated before further evaluation.

Adult

Menstrual patterns after laparoscopic sterilization using a spring-loaded clip.

Details of the menstrual cycles in 504 women were recorded before laparoscopic sterilization with a spring-loaded clip and at six months and one year after the procedure. The operation did not affect the length of the menstrual cycle or duration of menstrual flow, nor the patient's assessment of the amount of blood losss or the incidence of dysmenorrhoea. The previous method of contraception was significantly related to subsequent menstrual patterns.

Adult

[Clip markings of the uterus and the urinary bladder for the dosimetry of intracavity and percutaneous radiotherapy (author's transl)].

The exact marking of certain regional landmarks of the anatomy permits the determination of the co-ordinates of these points by stereoscopic diagnostic radiology. The mid-point of the upper margin of the symphysis is selected as the origin of the co-ordinates. The markings of the uterus are placed through the laparoscope with silver clips. The markings in the urinary bladder are placed close to the ureteral orifices through the cytoscope. The doses of radiation generated by the sources of radiation (tubes, colpostat, vaginal cylinder, cervical plate) can with this new marking technique not only be measured experimentally in anatomically well-defined points in the body but the dosage (the energy) can be calculated by the computer. In as many points in the body as desired. The maximal permissable dosage in the tumor can be determined with special consideration for the avoidance of radiation lesions to marked adjacent points such as the ureteral orifices.

Computers

Female sterilization by laparoscopy: a comparative study of tubal occlusion with electrocoagulation and spring-loaded clip with one-year follow-up.

Findings are reported of a study conducted to evaluate and compare the safety and effectiveness of the spring-loaded clip and the electrocoagulation techniques of tubal occlusion via laparoscopy. The study was conducted from June, 1974 to June, 1975 on 300 cases in a Bangkok, Thailand hospital. Only patients who requested sterilization to limit family size were included in the study, and study patients were required to return for 6- and 12-month follow-up visits. To minimize possible patient and physician biases, all sterilization procedures were performed by one author (S. K.). and data were analyzed by the other author (S. P.). The specific operative technique was randomly assigned to the patient immediately prior to surgery, and the patient was unaware of the particular technique used. The findings showed no potentially serious complications for either technique. Neither complication rates nor incidence of pain were significantly different for the two procedures. The presence of adhesions was the most frequent cause of surgical difficulty in both techniques. No mechanical difficulties were reported. No pregnancies were reported within one year of sterilization.

Adolescent