Laparoscopic sterilizations (16,803) without vaginal manipulation

Laparoscopic sterilization is usually done after viewing the fallopian tubes brought into the laparoscopic field by a uterine manipulator introduced through the vagina. The orthodox rural Indian women, however, resent vaginal manipulation exposing their genitalia. Therefore, the author developed a single-puncture technique for performing laparoscopic sterilization with a Falope-Ring, which dispenses with a uterine manipulator. Experience with 16,803 cases is presented. This technique is recommended for mass sterilizations because it eliminates the risks involved in vaginal manipulation and enhances acceptability and popularity of the procedure. Nonetheless, the risks of bowel injury are augmented, and the method is not for the inexperienced or occasional operator.