A new technique for female sterilization.

The normal mobility and inherent length of the fallopian tube make possible its exteriorization from the abdominal cavity to perform tubal sterilization. The authors offer a new laparoscopic technique using exteriorization of the tube, performance of either tubal ligation (modified Pomeroy technique) or unipolar cauterization, and intra-abdominal in-sleeve cauterization in case of failure to exteriorize the tube. This approach averts laparotomy, preserves the advantages of tubal ligation, and precludes bowel injury that may result from using electric cauterization. To ensure safety an uninsulated trocar sleeve and grasping forceps were designed and used through the second puncture site. With this technique, 364 patients have had voluntary interval sterilization at the UCLA-Olive View Medical Center between 1977 and 1980, including tubal ligation (181 patients), cauterization (161), and intra-abdominal in-sleeve cauterization (22). No bowel burn was occurred and no laparotomies have been necessary. Complications were minor and compared favorably with other laparoscopic sterilization techniques.