Minilap, Laparoscopic Sterilization Both Effective, But Failure Rates Vary with Occlusive Techniques

Abstract

A life-table analysis of sterilizations in Singapore found minilap to be more effective than any other procedure. A multicenter life-table analysis based on experience in 24 countries found little difference in effectiveness. Singapore investigators noted that the method of tubal occlusion used with laparoscopy may have contributed to the high failure rate. Results from the multicenter group on 12-month pregnancy rates following minilaparotomy were similar to those of the Singapore group: .04/1000 compared to .02/100 (Singapore). The rate following laparoscopic sterilization was lower, .03/100 compared to 3.6/100 (Singapore). The main reason for laparoscopic failure was incomplete cauterization. Laparoscopy should be employed in institutions where the equipment required is cost-effective and where a large caseload would ensure that the surgeon's skills are maintained. For obese patients, or those with restricted uterine mobility, laparoscopy may be preferred.