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Fallopian Tubes
and Ovaries

Laparoscopy Technique

Diagnostic Uses
of Laparoscopy

of Tubal Patency
via Laparoscopy

Laparoscopic Resection
of Unruptured
Ectopic Pregnancy

Ovarian Biopsy
via Laparoscopy

Electrocoagulation of
Endometriosis via

Lysis or Adhesions
via Laparoscopy

Control of Hemorrhage
During Laparoscopy

Fallopian Tube

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




Tuboplasty -
and Anastomosis
of the Fallopian Tube

Wedge Resection
of the Ovary

Torsion of the Ovary

Ovarian Cystectomy

Sterilization by the Modified
Irving Technique

The modified Irving operation was proposed to prevent the small but persistent incidence of failures associated with the Pomeroy procedure. Although prospective randomized studies are unavailable at this writing, this operation is regarded as one of the most effective for prevention of pregnancy.

The purpose of the procedure is to prevent pregnancy by obstructing the Fallopian tubes by burying their proximal portions back into the myometrium.

Physiologic Changes.  The physiologic changes with the modified Irving technique are similar to those associated with the other methods of tubal obstruction and ligation. In addition, the proximal portion of the Fallopian tube is buried within the myometrium. This makes recanalization or the development of a tuboperitoneal fistula extremely unlikely.

Points of Caution. An adequate opening in the myometrium must be made with the straight mosquito clamp if the Fallopian tube is to be pulled within the myometrium.


The abdomen is opened through a transverse or lower midline incision. The Fallopian tube is grasped with an Allis or a Babcock clamp. A small Halsted hemostat is used to open the mesosalpinx.

Two 0 synthetic absorbable sutures are passed through this opening.

The sutures are tied, and the segment of Fallopian tube is transected and removed. The tie on the distal segment of the proximal portion of Fallopian tube is threaded onto two French eye needles.

A mosquito hemostat is used to open a 6-mm defect in the posterior wall of the uterus in the cornual region.

The French eye needles are passed through this defect, one after another, and the suture is tied, pulling the proximal portion of the Fallopian tube into the defect.

The completed operation shows both proximal portions of the Fallopian tube buried within the myometrium. The distal portions of the Fallopian tube are ligated and left in place.

The abdomen is closed in layers.

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