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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

Hulka Clip Sterilization
via Laparoscopy

Laparoscopic Hulka clip application for female sterilization differs from the other methods of laparoscopy sterilization in that it applies a spring-loaded Silastic clip to the Fallopian tube. It has the advantage of producing the least tissue damage to the Fallopian tube and, therefore, may prove to be the most reversible form of female sterilization. The laparoscopic technique is the same as previously described for other laparoscopic procedures.

The purpose of the operation is to effect female sterilization.

Physiologic Changes. The oocyte and spermatozoa are prevented from meeting in the midportion of the Fallopian tube.

Points of Caution. Care must be taken to ensure that the Hulka clip is over the entire Fallopian tube and that the tips of the clip grasp a small portion of mesosalpinx.

Technique

With a loaded clip applier next to the Fallopian tube, 2-3 mL of 1% Xylocaine solution are pushed through the clip applier and sprayed on the Fallopian tube for local anesthesia.

The surgeon opens the clip by activating the shaft retractor at the end of the clip applier. The same mechanism is used to close the clip and lock it into position with its metallic spring.

The clip has been applied to the Fallopian tube. It is released from the clip applier when the surgeon withdraws the shaft to the extreme position.

The same procedure is performed on the opposite tube. The surgical instruments are withdrawn, and the gas is released through the remaining trocar sleeve. The incision is closed with 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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