Back

Methods used for tubal sterilization include post-partum partial salpingectomy, unipolar coagulation, bipolar coagulation, spring clip, silicone rubber band, or interval partial salpingectomy (Cunningham et al., 2013d). Commonly, the approach is laparoscopic, although minilaparotomy may also be used, particularly in the case of postpartum partial salpingectomy. Lowest failure rates are found with postpartum partial salpingectomy and unipolar coagulation.

• Newer tubal sterilization techniques, using a transcervical hysteroscopic approach, are available and offer advantages of effectiveness and placement without general anesthesia or laparoscopy. The Essure device is an expanding spring device made of titanium, stainless steel, and nickel that contains Dacron fibers to induce an inflammatory response and final fibrosis of the intramural tubal lumen (Wieslander & Wong, 2013). The Adiana device causes tubal occlusion through a combination of radio-frequency tubal endocoagulation and the implantation of a silicone matrix (Smith, 2010). Evaluation of the effectiveness of these newer techniques continues.