Discussion of laparoscopic sterilization in a community hospital with a two-year follow-up given by Dr. Joshua Tayloe.

The results presented elsewhere of a 2 year follow-up study of laparoscopic sterilizations performed with coagulation techniques were discussed and the results of this study and similar studies were used to develop a list of advantages and disadvantages of performing laparoscopic sterilizations. In recent years the number of physicians using coagulation techniques increased. A poll conducted by the American Association of Laparoscopists in 1975 revealed that 21.4% of the physicians used coagulation only techniques 40% used coagulation with division and 30.6% used coagulation with division and excision. In the 2 year follow-up study Dr. Tayloe performed sterilizations by coagulation and division and reported 2 failures. In 1 of these cases the tubes were not completely visualized and 1 tube was not coagulated. In the other case recanalization occurred. In other series reported between 1973-1976 the laparoscopic sterilization failure rates ranged from 2.0-0. Advantages associated with laparoscopic sterilization are that it 1) is high effective; 2) provides for high visualization of the pelvic area; 3) can be performed on an outpatient basis; and 4) can be performed quickly. The disadvantages associated with laparoscopic sterilization are that it 1) requires expensive and sophisticated equipment; 2) offers little chance of reversal; 3) has a high burn risk; and 4) must be performed by highly experienced operators. Experience indicates that laparoscopic tubal sterilization is contraindicated for patients with a history of intraperitoneal surgery and that laparoscopic sterilization patients frequently require subsequent pelvic surgery for a variety of reasons.