USE OF MULTIPLE CLIPS FOR TUBAL OCCLUSION IN INTERVAL LAPAROSCOPIC STERILIZATION - CIRCUMSTANCES AND CONSEQUENCES

The use of multiple clips for the occlusion of the Fallopian tubes has been reported in interval laparoscopic sterilization, but the circums tances leading to the performance of the multiple-clip procedure and i ts effects on safety and efficacy have not been carefully studied. A d ata set from international multi-center clinical trials of Filshie cli ps and Wolf (Hulka) clips was used to examine the possible reasons for performing this procedure for 102 women. Their complications, complai nts, and surgical and post-surgical events before discharge and during one month of follow-up were compared with those of the 408 women whos e tubes were occluded by single clip. Results indicate that multiple c lips were most often used when surgical difficulties (and to a much le sser degree, tubal and/or mesosalpingeal injury) were encountered duri ng the sterilization procedure. No increased risk of short-term compli cations or complaints (including pelvic pain) was found at one-month f ollow-up for those patients who received multiple clips.