[Operative complications of laparoscopic tubal sterilization with Bleier clips (author's transl)]

The operative complications of 1613 laparoscopic tubal sterilization with Bleier clips were evaluated in a prospective study at the Stadtkrankenhaus Offenbach/M from March 1978 to July 1981 (1239 interval and 374 postabortal procedures; two-puncture technique under general endotracheal anaesthesia). No major complications requiring laparotomy occurred. Minor intraoperative complications were observed in 8.4% of cases. Clip-related problems were encountered in 1.9% (slight tubal or mesosalpingeal bleeding). Other complications included haemorrhage at the puncture site (2.4%), preperitoneal emphysema (1.8%) and uterine perforation during curettage (1,6%). Technical difficulties were recorded in 8,4% of sterilizations; in 6.6% more than one clip per tube was placed to effect complete tubal occlusion. Adnexal pathology prohibited bilateral clip application in 4 women (0.3%). Postoperative complications were negligible. No pregnancies have yet been reported during a mean follow-up period of 17 months. A successful refertilization procedure was performed on one patient. It is concluded that this technique represents a commendable alternative to convention methods of tubal sterilization due to its low operative morbidity, acceptable contraceptive safety and potential reversibility.