Use of the Laparoscopic Pomeroy Tubal Ligation in a Residency Training Program

To evaluate the efficacy of the laparoscopic Pomeroy method of tubal ligation as a method for the initial acquisition of advanced laparoscopic skills, a y prospective, non-randomized study was done on 57 consecutive patients undergoing permanent sterilization using the Pomeroy technique involving videolaparoscopy, a three puncture approach, and plain catgut endoloops. Fifty-three of 56 patients completed the study. Two patients with previous multiple Cesarean sections required minilaparotomies and one patient's hospital data could not be located. Fourteen residents in a 28 person program were evaluated; 5 were first year residents, 2 were second year, 3 were third year, and 4 were fourth year. The average operative time for the PGY-1, PGY-2, PGY3 and PGY4 residents were 18.6, 15.4, 21.7, and 14.8 minutes respectively. No significant difference in operating time between residents within years (p=.54) or at differing PGY levels (p=.64) were noted. The time required to do each subsequent case diminished with experience. There were two minor complications. We conclude that the application of the laparoscopic Pomeroy tubal ligation as a method to begin educating residents in advanced operative video laparoscopy has great potential.