Intraoperative complications of interval tubal sterilization
– 4
years experience at a teaching hospital
B. Dilbaz, D. Akdag, H. Cengiz, S.
Dilbaz, A. Akyunak, A. Haberal
MoH Ankara Etlik Maternity and Women’s Teaching
and Research Hospital, Department of Family Planning, Ankara, Turkey
Objective
To evaluate the complications of interval tubal sterilization.
Design and methods
The demographic characteristics, operative technique and intra- and
postoperative complications of 461 consecutive patients who had interval tubal
ligation (ITL) as a day case between 2002-2005 were evaluated. Only 11 patients
had minilaparotomy for ITL whilst the remaining had laparoscopic tubal
coagulation via bipolar cauterization. All the procedures were carried out under
general anaesthesia and cases were followed up for 5 hours and discharged if no
complications occurred. The patients came for follow-up visit one week after
surgery and the operation-site was examined. The cases who were hospitalized or
who had a complication and/or an unplanned laparotomy were analyzed.
Results
The average age, gravidity, parity and number of living children of patients
were 35.1(R:21-51, Sd ± 7.2); 4.6(R:2-9, Sd ± 1.3); 3.3(R:2-7, Sd ± 0.8); 3.2
(R:2-6, Sd ± 0.8) respectively. Sixty-one percent had completed primary school,
23% were illiterate, 8% had secondary school education whilst 8% were high
school graduates. Of the patients only 2 (0.4%) had complications related with
general anaesthesia; one case had bronchospasm and another was diagnosed to have
pseudocholine esterase deficiency. Two cases (0.4%) had bleeding from the
port-site that needed to be cauterized, three cases (0.6%) had meso-salphingeal
and meso-ovarian bleeding that was cauterized. One omental bleeding (0.2%), one
bleeding (0.2%) from the vaginal wall due to a laceration that occurred during
the insertion of the speculum were the other 2 complications.There was only one
(0.2%) intestinal burn that required a laparotomy and segmental resection
followed by end-to-end anastomosis. There was no postoperative complications.
The mortality was nil whilst the morbidity was found to be 2.1% and all the
complications were encountered in patients who had laparoscopic surgery. Apart
from the patient who had intestinal injury the complications were handled
efficiently using the endoscopic technique.
Conclusions Out-patient tubal
ligation is a convenient and safe procedure and implementing endoscopic surgical
techniques is necessary for correction of the complications.