Laparoskopic Sterilization by Filshie Clip: Prospective Study of 180 Patients

Overview

Objective:
In this prospective study from 1997-2000, authors have been analyzing preliminary results of 180 tubal sterilizations, which were performed by method of the laparoscopic application of Filshie clips.Design: Prospective study.Setting: Department of operative gynaecology and minimally invasive surgery. Hospital Na Homolce, Prague.Methods: The procedures were performed in accordance with the still valid Public Notice of the Czech Republic Ministry of Health n. 1/1972, §5/1972. The mean age of the patients was 38,6 years, with each patient having 2,1 living children on average. During the intervention 42% of the patients either had IUD or were taking a hormonal contraceptive, while 29% of the patients had in their history a record of previous abdominal surgery.Results: The average duration of the operation (from the incision to the closure) was 14 min.There were no per- or postoperative complications and until the present we have no knowledge of failure. In the view of both the patient and the surgeon, this is the most acceptable procedure.Conclusion: In accordance with the British (RCOG) and the Canadian Gynecological Society conclusion and also on the basis of many randomized studies and recommendations from WHO, we conclude that the laparoscopic approach with the mechanical tubal occlusion by means of the clip is the first choice method. Our previous experience and meta-analytic studies of the literature, demonstrate that from all accessible clip methods, the Filshie clip method is the most suitable as it has the lowest failure rate, the least occurrences of extrauterine gravidity (in a case of failure). Most importantly it is a simple, quick and easily taught method. Another potentially significant factor is the highest rate of successful reversibility.

Key words:
sterilization, laparoscopy, mechanical methods, Filshie clip