Open laparoscopy for tubal occlusion in the female

Open laparoscopy was performed in 630 patients seeking permanent contraception for health reasons. Various electric and mechanical tubal occlusion methods were utilized. With few exceptions, uterine curettage was performed at the end of the laparoscopic procedure. Curettage revealed unexpected findings in 10 cases. Laparoscopic exploration of the peritoneal cavity showed pathologic findings in 10% of the patients. There were no intraoperative complications related to open laparoscopy. Fourteen patients (2%) underwent immediate laparotomy, to manage unexpected findings in six and to correct complications of unipolar tubal cautery technique in eight. Postoperative complications possibly related to open laparoscopy were limited to minor wound infection in 0.3% and febrile reaction of short duration in 0.1% of the cases. Two sterilization failures occurred in the series, both following unipolar techniques employing coagulation and resection. Many patients have now been followed for 5 or more years without noticeable increases in complaints of uterine bleeding and/or pelvic pain. The data indicate that open laparoscopy is a suitable means of performing tubal sterilization in the female.