A four-year experience with Yoon ring.

Endoscopic sterilization with the Yoon ring has been the principal method of interval sterilization at the authors institution for the past 4 years because of its ease of application effectiveness and minimum of associated complications. It is done laparoscopically as an outpatient procedure performed under local anesthesia. The Yoon ring is made of nontissue reactive silicone rubber with 5% barium sulfate and has a specific elastic power of 90% to 100% memory if not stretched for more than 6 mm. The procedure for carrying out this type of sterilization is described in detail. 2098 cases were performed from October 1973 through October 1977 at the authors institution. The patients were followed up at various intervals after surgery. Of the 2098 cases 1976 were included in the statistical analysis. An overall 5.7% incidence of direct complications occurred in 114 patients with tubal transections being the most significant (it occurred in 3.5% or 69 patients). 24 of these 69 cases were related to some form of pelvic inflammatory disease. 63.8% of the cases of transection were managed by reapplication of a Yoon ring to each of the divided segments to control hemostasis and effect tubal closure. 5 pregnancies occurred and were associated with the ring device or method. Per life table analysis the cumulative pregnancy rate of the followed up patients was 0.38 at the 12- and 24-month intervals. The Yoon ring method is safe effective and simple. In addition it eliminates possibility of thermal bowel injury and carries a greater chance of successful reversal.