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Fallopian Tubes
and Ovaries

Laparoscopy Technique

Diagnostic Uses
of Laparoscopy

Demonstration
of Tubal Patency
via Laparoscopy

Laparoscopic Resection
of Unruptured
Ectopic Pregnancy

Ovarian Biopsy
via Laparoscopy

Electrocoagulation of
Endometriosis via
Laparoscopy

Lysis or Adhesions
via Laparoscopy

Control of Hemorrhage
During Laparoscopy

Fallopian Tube
Sterilization

Sterilization by
Electrocoagulation and
Division via Laparoscopy

Silastic Band Sterilization
via Laparoscopy

Hulka Clip Sterilization
via Laparoscopy

Sterilization by the
Pomeroy Operation

Sterilization by the
Modified Irving Technique

Sterilization by the
Minilaparotomy Technique

Sterilization - Ucheda Technique

Salpingectomy

Salpingo-oophorectomy

Fimbrioplasy

Tuboplasty -
Microresection
and Anastomosis
of the Fallopian Tube

Wedge Resection
of the Ovary

Torsion of the Ovary

Ovarian Cystectomy

Silastic Band Sterilization
via Laparoscopy

The Fallopian tube can be adequately obstructed by the application of a Silastic band to a knuckle of Fallopian tube. This produces necrosis of the tube from ischemia and, thereby, causes tubal obstruction. It has an advantage over the electrocoagulation technique in that it is equally successful, statistically, preventing pregnancy and avoids the possibility of electrothermal burns.

The purpose of the Silastic band applied by laparoscopy is to obstruct the Fallopian tube to achieve female sterilization.

Physiologic Changes. The Fallopian tubes are obstructed.

Points of Caution. Care must be taken not to bring an excessively large knuckle of Fallopian tube into the housing of the banding scope. If a large mass of Fallopian tube, with associated mesosalpinx, is brought into the housing of the laparoscope, the grasping tongs will lacerate the tube.

Technique

The uterus is anteflexed by manipulating the Rubin cannula and Jacobs tenaculum. The Fallopian tube is visualized and then is grasped with the tongs of the Silastic band instrument, which has been previously loaded with a Falope ring.

The Fallopian tube is drawn into the Silastic band applicator, and the Falope ring is pushed off the applicator onto a knuckle of tube.

The knuckle of tube is released from the grasping tongs.

If Silastic band sterilization is desired by the two-incision technique, the second-incision instrument is inserted as in Figure 18, under Laparoscopy Technique and the Silastic band applicator is inserted through the second-incision trocar into the lower abdomen.

The Fallopian tube is again located, and the second-incision Silastic band applicator is used to draw the Fallopian tube into the applicator and push the Silastic band over a knuckle of Fallopian tube.

When the operation has been completed, either by the one-incision or two-incision technique, the pelvic area is thoroughly inspected to see that both tubes are adequately banded and that there is no hemorrhage.

The instruments are withdrawn, and the incision is closed with a single 3-0 synthetic absorbable suture.

  

Copyright - all rights reserved / Clifford R. Wheeless, Jr., M.D. and Marcella L. Roenneburg, M.D.
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