Laparoscopic sterilization under local anesthesia. 1200 cases

Laparoscopic tubal fulguration operations were performed on 1200 patients under local anesthesia in two free-standing surgical units in Syracuse, New York, between June 1972 and March 1976. No operative accidents occurred. However, because of increasing understanding of the risks to major blood vessels from needle and trocar insertion, all patients undergoing laparoscopy since March 15, 1976, have received the additional safeguards of an operating room with full anesthesia and laparotomy capabilities. The major technical innovation in this series of operations was the use of the 23-guage needle cannula, inserted through the Wolf operating laparoscope for preliminary Xylocaine infiltration of the fallopian tubes. The advantages of local over general anesthesia are summarized.