A variety of methods are available including: (1, 2)
- Falope ring - plastic ring placed around both limbs of a loop of tube previously drawn into an applicator tube
- Hulka-Clemens clip - spring loaded tube clip placed across tube - not a loop of tube
- electrocoagulation - two adjacent segments of tube burnt with / without transection; not recommended in younger women as tends to destroy a large area of tube making reversal unlikely; not widely used in this country
- Pomeroy ligation - knuckle of tube tied and excised on each side
- Filshie clip - clips effect sterilisation by causing avascular necrosis at the site of clip application, with each tube eventually dividing to leave two healed and occluded stumps
The Falope ring and Hulka clip may be used in either a laparoscopic approach or in posterior colpotomy.
The Pomeroy technique may be used in either a laparotomy, mini - laparotomy or posterior colpotomy. It is generally employed when performing a post-partum tubal occlusion.
References:
- Hatcher R. Contraceptive technology. 21st ed. New York: Ardent Media; 2018.
- Lawrie TA, Kulier R, Nardin JM. Techniques for the interruption of tubal patency for female sterilisation. Cochrane Database Syst Rev. 2016 Aug 5;(8):CD003034.