Ongoing program of outpatient sterilizations.

The advantages to the patients of tubal coagulation by laparoscopy as a means of sterilization are obvious in terms of convenience efficiency and cost. Additionally complications have been few and very minor. Among a series of 600 patients 6% had been done for medical reasons and 17% had undergone previous lower abdominal surgery. The age range has been from 20-49. Very careful screening of patients is important since tubal coagulation must be regarded as an irreversible procedure. A 7-day waiting period between the decision to operate and the procedure itself has been mandatory. The patients receive intravenously and slowly diazepam (Valium) and meperidine (Demerol). After the 1st 10 sterilization procedures in which a bilateral tubal coagulation was performed and a segment of each fallopian tube was excised only bilateral tubal coagulation has been performed. There has been no further evaluation by any other diagnostic procedure. There were only 7 minor complications among the 600 patients. There have been over 600 surgical procedures performed and for every procedure started there has been a completion. Bleeding immediate or delayed has not occurred. 2 patients 1 month after the surgical procedure and after a menstrual period developed pelvic discomfort and a low-grade temperature. 1 ectopic pregnancy has occurred. There have been 4 hysterectomies because of pelvic pain and recurrent dysfunctional uterine bleeding and 1 hysterectomy for extensive endometriosis.