Mechanism of single-stitch failure of tubal ligation: a morphologic appraisal

The widespread demand for a simple, safe, and reversible sterilization procedure has attracted the attention of clinicians and researchers. A simple ligation with a single suture of nonabsorbable linen, involving a very small segment of tube (1 mm) in the isthmic portion about 1 cm from the isthmic ampullary junction, was used in 463 multiparous women. Of the 363 cases followed for a period of 1--3 years, there have been 52 failures. In 10 unsuccessful cases total abdominal bilateral salpingectomy was performed, and a detailed histologic study of these 20 tubes was instituted in an attempt to understand the mechanics of failure of the single-stitch technique. This is the first such study to be reported.