Training of residents in laparoscopic tubal sterilization: long-term failure rates.
OBJECTIVE
Laparoscopic tubal sterilization with bipolar coagulation is a common and effective method of contraception, and a procedure much used to teach laparoscopic surgical skills to Obstetrics and Gynaecology residents (trainees); but it has an inherent risk of failure. This study investigated the long-term failure rate of this procedure when performed by Obstetrics and Gynaecology residents on women treated in their teaching clinics.


METHODS
From 1991 to 1994, Obstetrics and Gynaecology residents carried out 386 laparoscopic tubal sterilizations with bipolar coagulation at Yale-New Haven Hospital. Six to nine years after the procedure, the women concerned were contacted by telephone and data were collected about sterilization failure.


RESULTS
Two failures of laparoscopic tubal sterilization with bipolar coagulation were identified: an ectopic pregnancy and a spontaneous abortion. For this time period, the long-term sterilization failure rate was 1.9% (0-4.4%).


CONCLUSIONS
The long-term sterilization failure rate for laparoscopic tubal sterilization with bipolar coagulation performed by residents is comparable to the results of prior studies. These findings can be used to properly counsel women at a teaching clinic about the risks of sterilization failure with this procedure, and attest to the adequacy of residents' training and supervision.
Rackow
Beth W
BW
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA. beth.rackow@yale.edu
Rhee
Maria C
MC
Taylor
Hugh S
HS
D000328:Adult; D002425:Cautery; D003237:Connecticut; D005260:Female; D005500:Follow-Up Studies; D006176:Gynecology / Q000193:education; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000706:statistics & numerical data*; D009774:Obstetrics / Q000193:education; D011247:Pregnancy; D011271:Pregnancy, Ectopic; D013246:Sterilization, Tubal / Q000193:education* / Q000706:statistics & numerical data*; D017211:Treatment Failure