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At least 19 recordsLinked to original sources
PubMed1976

A comparative study of electrocoagulation and tubal rings for tubal occlusion at laparoscopy.

The surgical and early postoperative complications and complaints associated with laparoscopic sterilization using electrocoagulation or tubal rings for tubal occlusion were evaluated in a comparative study. Procedures were randomly assigned to subjects (electrocoagulation to 151 subjects and tubal rings to 148 subjects). Difficulties in carrying out the sterillization procedures occurred more frequently when tubal rings were used (6.1%) than when electrocoagulation was used (2.0%). Rates of complications occurring at the time of surgery were similar for the two procedures. However, one patient in the electrocoagulation group had a bowel burn. Postoperative pelvic and abdominal pain were reported by a significantly higher proportion of the tubal ring cases (32.0%) than electrocoagulation cases (19.4%). It appears that although the incidence of surgical difficulties and pain may be somewhat more frequent with the tubal ring, the avoidance of such potentially serious complications as bowel burns may make femal sterilization by the tubal ring method preferable.

Electrocoagulation↗
PubMed2000

Two randomized controlled trials comparing the tubal ring and filshie clip for tubal sterilization.

OBJECTIVE: To compare the effectiveness and safety of the Filshie Clip and Tubal Ring systems when applied via minilaparotomy and laparoscopy. DESIGN: Prospective, multicenter randomized controlled clinical trial, with postoperative evaluation by a physician who was masked to the operative technique. SETTING: Healthy volunteers in a variety of hospital settings. PATIENT(S): 2746 women (915 in the minilaparotomy study and 1831 in the laparoscopy study) who had requested permanent surgical sterilization. INTERVENTION(S): Surgical tubal ligation, using either Filshie Clips or Tubal Rings. A physician other than the surgeon evaluated the patients after the operation and again at 1, 6, and 12 months after surgery. MAIN OUTCOME MEASURE(S): Pregnancy rates and safety-related events. RESULT(S): During the 12 months after surgery, two women who received the Filshie Clip and two women who received the Tubal Ring became pregnant, giving a 12-month life-table pregnancy probability of 1.7 per 1000 women in both groups. The Tubal Ring was more difficult to apply and had higher rates of tubal or mesosalpingeal injuries at surgery. The Filshie Clip group had three cases of spontaneous clip expulsion during the follow-up period. CONCLUSION(S): Both the Filshie Clip and Tubal Ring are effective and safe for use in tubal occlusion.

Adult↗
PubMed2001

Comparison of tubal ring and corpus luteum echogenicities: a useful differentiating characteristic.

The purpose of this report is to compare the echogenicity of the tubal ring of an ectopic pregnancy and the corpus luteum with that of the ovary for improved detection of early ectopic pregnancy. In patients with ectopic pregnancy diagnosed at sonography on the basis of the presence of an adnexal tubal ring, echogenicity of the ring was compared with the echogenicity of the ovarian parenchyma. Twenty-six patients with tubal rings containing either a yolk sac or cardiac activity were included. Twenty-three (88%) of the 26 tubal rings had echogenicity equal to or greater than that of ovarian parenchyma. In 13 patients with ectopic pregnancy diagnosed on the basis of an empty tubal ring, 10 rings (77%) were more echogenic than the ovary. In 45 control patients with intrauterine pregnancy, the corpus luteum was more echogenic than the ovary in only 3 (7%). The tubal ring of an ectopic pregnancy is usually more echogenic than ovarian parenchyma, and the corpus luteum is usually equal to or less echogenic than the ovary. Echogenicity of an adnexal mass may help distinguish the tubal ring of an ectopic pregnancy from a corpus luteum.

Adult↗
PubMedDate not supplied

Comparison of laparoscopic sterilization via spring-loaded clip and tubal ring.

The spring-loaded clip and tubal ring techniques of laparoscopic female sterilization were compared for ease of performance, safety and effectiveness at the Asociación Demográfica Salvadoreña in San Salvador, where they were randomly assigned to a total of 299 patients. Rates of technical/equipment difficulties and procedural difficulties during laparoscopy were similar for both techniques. Procedure-related surgical complications occurred in three ring patients as a result of tubal transection. Pain during the procedure was more severe for tubal ring patients. Results suggest that both techniques can be safely and effectively used for laparoscopic sterilization.

Adult↗
PubMed1985

A comparative clinical trial of the tubal ring versus the Rocket clip for female sterilization.

Studies of application of the Rocket clip compared with the tubal ring were conducted at three sites. Procedures were randomly assigned to the patients; 332 women were sterilized with the tubal ring and 331 were sterilized with the Rocket clip. The occlusion devices were applied via a minilaparotomy incision. Surgical difficulties and injuries and technical failures occurred with comparable frequency in the two groups. There were two method failures in each tubal occlusion group; the 24-month life-table pregnancy rate was 1.0 per 100 women in the tubal ring group and 0.9 per 100 in the Rocket clip group. The Rocket spring-loaded clip appears to be as safe, effective, and easy to apply as the tubal ring for tubal occlusion.

Adult↗
PubMed1985

Comparison of interval and postabortal/puerperal laparoscopic sterilization with the tubal ring procedure.

During a 5-year period, 344 women underwent laparoscopic sterilization with the tubal ring. Complications and failure rates were compared in intervals and postabortal/puerperal procedures. Only 9% were lost to follow-up, and 50% underwent a hysterosalpingoghraphy (HSG). The comparison of interval and postabortal/puerperal procedures showed no significant differences in complication rates, but postabortal/puerperal laparoscopy had a significantly lower failure rate than interval procedures (p less than 0.01). It was found that women whose laparoscopy was carried out despite peroperative complications had a significantly higher risk of sterilization failure (p less than 0.005). It is concluded that postabortal/puerperal laparoscopic sterilization with the tubal ring procedure is as safe as interval sterilization, and it is strongly recommended that peroperative complications with tubal ring sterilization should result in a reversion of the laparoscopy to a laparotomy and, if not, that the women be referred for HSG.

Abortion, Spontaneous↗
PubMed1981

Severe pelvic inflammatory disease and peritonitis following Falope Ring tubal ligation. Case report and review of the literature.

A case of severe pelvic inflammatory disease and peritonitis following Falope Ring tubal ligation is described. Pelvic viscera appeared normal at the time of laparoscopy. Severe pelvic inflammatory disease and peritonitis should be included in the differential diagnosis of patients presenting with significant abdominal pain following Falope Ring tubal ligation. The problem of serious pelvic infection following Falope Ring tubal ligation is reviewed.

Adult↗
PubMed1986

Late sequelae following laparoscopic sterilization employing electrocoagulation and tubal ring techniques: a comparative study.

Data on 211 consecutive laparoscopic sterilized women were compared. Half the patients were sterilized using unipolar electrocoagulation and the rest had tubal rings. The period of observation was 21-50 months, median 36.5 months. Four failures were observed, median 15 months after the operation. Pregnancy rates were 0.32 per 100 woman years using electrocoagulation and 1.02 using tubal rings. A total of 11% had experienced low abdominal pain and 4% dyspareunia. Menstrual pattern changes were reported by 31% in the electrocoagulation group and 43% in the tubal ring group. The rates of late sequelae were statistically significant independent of the technique employed.

Dyspareunia↗
PubMed1980

Technical failures in tubal ring sterilization: Incidence, perceived reasons, outcome, and risk factors.

Six centers participated in comparative studies of female sterilization conducted by the international Fertility Research Program. The incidence of technical failures (or failed attempts) was compared between patients sterilized with the tubal ring and those sterilized with other tubal occlusion techniques. The tubal ring was associated with a higher failure rate than electrocoagulation, the Rocket clip, or the modified Pomeroy technique. Of 1,035 tubal ring sterilizations, there were 38 technical failures. Reasons given by the operators for the failures, by frequency of occurrence, were surgical complications, conditions preexisting in the patients, and problems with the instruments. Most of these failures were remedied by changing to other techniques. In two patients, the procedure was completed by changing the approach from laparoscopy to laparotomy. In five others, sterilization was not completed. Case-control analysis was performed and three risk factors were delineated: obesity, prior use of an intrauterine contraceptive device and previous abdominal operations.

Abdomen↗
PubMed1978

Laparoscopic electrocoagulation and tubal ring techniques for sterilization: a comparative study.

From August 1975 through May 1976, a comparative study was made of the effects of sterilization by standard electrocoagulation and tubal ring application techniques. The two techniques were randomly assigned to 300 patients. Results show that standard electrocoagulation and tubal ring procedures can easily and safely be performed on an outpatient basis, using local anesthetics and analgesics. Rates of surgical complications for both techniques were clinically acceptable, although tubal risk patients had a higher rate. Pain during the procedure and during the immediate recovery period was more severe for tubal ring patients. Despite the higher incidence of surgical complications and pain associated with the ring, many physicians prefer this method of sterilization because it eliminates the possibility, inherent in electrocoagulation, of inadvertent serious electrical burns.

Adult↗
PubMed1979

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↗
PubMed1988

Four-year follow-up of electrocoagulation and tubal ring sterilizations in Costa Rica.

An earlier analysis of 299 laparoscopic sterilizations comparing electrocoagulation and tubal ring occlusion techniques found no significant differences in rates of surgical complications. The risk of potentially serious complications, such as bowel/bladder burns, was considered higher with electrocoagulation be the preferred technique. Examination of the same women through 48 months poststerilization between the two techniques with respect to the incidence of gynecologic surgery performed subsequent to sterilization. Gynecologic abnormalities were similar for women in both groups. The rate of pregnancy was higher for tubal rings than for electrocoagulation (2.1 compared to 0.7 at 48 months) but this difference was not statistically significant.

Electrocoagulation↗
PubMed1976

Female sterilization using the tubal ring.

The surgical and early postoperative complications were evaluated in a study of 221 laparoscopies and 29 minilaparotomies in which tubal occlusions were performed with the application of tubal rings. For either procedure, complications were infrequent. None of the procedures had to be completed by another technique of tubal occlusion, and none of the patients required an extended hospitalization for the treatment of a complication. Among the 79 patients who have been followed up for more than 6 months, no pregnancies have been reported. The tubal ring technique appears to be safe and effective when used with either laparoscopy of minilaparotomy.

Adult↗
PubMed1981

Tubal ring sterilization: experience with 10,086 cases.

The safety and efficacy of the Silastic ring were examined for interval, postabortion, and postpartum sterilizations. The study includes an in-depth analysis of 10,086 cases generated by 51 collaborating institutions in 23 countries. Failure of the tubal ring is studied via the life-table method, although follow-up is limited to a relatively short period. Difficulties encountered when applying the ring, particularly those resulting in technical failure, are explored in detail. Surgical complications, infection, menstrual irregularity and abnormal bleeding, and pelvic surgery following sterilization are discussed. Comparisons are made among various approaches to the fallopian tubes. Such data are found to be similar to those for other occlusion techniques, demonstrating the comparable safety and efficacy of tubal ring sterilization.

Actuarial Analysis↗
PubMed1991

Method failures of laparoscopic tubal sterilization in a residency training program. A comparison of the tubal ring and spring-loaded clip.

A prospective, randomized study of 365 women undergoing interval laparoscopic tubal sterilization in a residency training program was undertaken to compare method failures. Two occlusive techniques were compared, the spring-loaded clip (Hulka-Clemens) and the tubal ring (Falope Ring). Patients were randomized to either Falope Rings or Hulka-Clemens clips as the primary method. Demographic characteristics, educational level and operator experience were similar in the two groups. Follow-up at an average of 16 months (range, 6-24) revealed eight pregnancies (4.5%) in 176 women in the clip group and five pregnancies (2.6%) in the ring group. The Hulka-Clemens clip and the Falope Ring have similar incidences of method failure when employed by inexperienced operators. We question the usefulness of chromopertubation utilizing methylene blue dye to ensure proper placement of the occlusive device.

Adult↗
PubMedDate not supplied

A comparative study of the tubal ring applied via minilaparotomy and laparoscopy in postabortion cases.

Sterilization with tubal rings applied via minilaparotomy or laparoscopy was performed on 300 randomly selected postabortion subjects to evaluate the safety and effectiveness of the two surgical methods. One hundred and forty-nine procedures were performed by minilaparotomy and 151 by laparoscopy. Gas leakage due to equipment problems was the most common technical difficulty during laparoscopy, and difficulty in exteriorizing the tubes was the most common surgical difficulty. Women undergoing laparoscopy experienced significantly less pain during surgery and had significantly lower rates of immediate and early postoperative complications than those women undergoing minilaparotomy. The rates of gynecologic abnormalities at six and 12 months were similar for both procedures. At this writing, no pregnancies have been reported among the study subjects. The results of our study indicate that laparoscopy is superior to minilaparotomy when it is performed in a controlled hospital situation.

Abortion, Induced↗
PubMed1986

Technical failures in female sterilization using the tubal ring: a case-control analysis.

To delineate characteristics of women predisposing to sterilization technical failures, we performed an analysis of 20 technical failures that occurred during tubal ring procedures and 80 control ring procedures matched on planned surgical approach and study site. None of the women had recently been pregnant (interval procedures). The odds ratios (ORs) were elevated for women wearing an IUD in the three months prior to sterilization (OR = 5.0, 90% confidence interval [CI] 2.2, 11.2) and for women with a history of spontaneous abortion (OR = 4.3, 90% CI 1.8, 9.8). A history of pelvic inflammatory disease (PID) and/or current evidence of PID was strongly associated with technical failure (X2 = 25.0, p less than 0.001). The combined effect of any two of these three factors increased the risk synergistically. We examined these factors prospectively and confirmed the elevated risks (relative risk [RR] = 5.0, 5.5 and 22.7 for recent IUD wearing, spontaneous abortion history and history/evidence of PID, respectively). The prospective analysis also found that previous abdominal surgery is associated with technical failure (RR = 6.7).

Abdomen↗