Technical problems and early complications of laparoscopic sterilization done on a day-case basis

Two hundred and sixteen patients were selected for laparoscopic sterilization on a day-case basis. Patients were sterilized by electrocautery, by applying Silastic bands (Falope rings), and by means of Hulka-Clemens clips. Three patients required laparotomy and 35 patients were discharged the day after the operation. By the 3rd day 146 (69%) and by the 5th day 184 (86%) patients had returned to their routine work. From the technical and immediate postoperative point of view, there appears to be relatively little difference between the three techniques. There may be slightly more risk of thermal complications with bipolar cauterization, a slightly highly incidence of postoperative abdominal pain with the Silastic band applicator, and slightly more difficulty in applying the Hulka-Clemens clip. These problems are all reduced by experience and proper training of the operator, which is essential. Our experience confirms that laparoscopic sterilization is safe, efficient, and feasible as a day-case procedure, and that it has major advantages in terms of patient convenience and acceptability as well as reduction in hospitalization costs.