An initial comparison of coagulation techniques of sterilization.
For nearly 50 years reports have been published on laparoscopic sterilization techniques. However, the different procedures vary greatly with regard to the extent of the tube destroyed and the magnitude of damage to the mesosalpinx. In 1981 we proved that a clear relationship exists between the extent of destruction of the circulation and nervous system within the mesosalpinx and the occurrence of menstrual disorders as well as menopausal symptoms. Because two-thirds of the ovarian blood supply passes through the ramus tubarius of the ateria uterina, after destruction of larger areas of the mesosalpinx striking disturbances within the ovarian metabolism must be expected. With numerous animal experiments we are currently studying the expansion of the coagulated area following the use of mono- and bipolar high-frequency current, endocoagulation and CO2 laser coagulation. With the aid of conventional histologic techniques, in addition to enzyme histochemical and electron microscopic examinations, attempts are being made not only to determine the extent of the destroyed zone but also to gain additional information on damage of the vascular and nervous systems of the tubes and ovaries. Although these studies have not yet been completed, it is possible at this time to state that the unipolar high-frequency coagulation technique, because of its tremendous primary and secondary complications, should not be used for laparoscopic female sterilization.
D000818:Animals; D002245:Carbon Dioxide; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D010535:Laparoscopy; D053685:Laser Therapy; D007834:Lasers / Q000379:methods*; D011817:Rabbits; D013243:Sterilization Reversal; D013246:Sterilization, Tubal / Q000379:methods*
D002245:Carbon Dioxide