of Tubal Patency
Division via Laparoscopy
Modified Irving Technique
Sterilization - Ucheda Technique
of the Fallopian Tube
of the Ovary
of the Ovary
Silastic Band Sterilization
The Fallopian tube can be adequately obstructed by
the application of a Silastic band to a knuckle of Fallopian tube.
This produces necrosis of the tube from ischemia and, thereby, causes
tubal obstruction. It has an advantage over the electrocoagulation
technique in that it is equally successful, statistically, preventing
pregnancy and avoids the possibility of electrothermal burns.
of the Silastic band applied by laparoscopy is to obstruct the Fallopian
tube to achieve female sterilization.
Physiologic Changes. The Fallopian tubes are obstructed.
Points of Caution. Care must be taken not to bring
an excessively large knuckle of Fallopian tube into the housing of
the banding scope. If a large mass of Fallopian tube, with associated
mesosalpinx, is brought into the housing of the laparoscope, the grasping
tongs will lacerate the tube.
The uterus is anteflexed by manipulating
the Rubin cannula and Jacobs tenaculum. The Fallopian tube is
visualized and then is grasped with the tongs of the Silastic
band instrument, which has been previously loaded with a Falope
The Fallopian tube is drawn into the Silastic
band applicator, and the Falope ring is pushed off the applicator
onto a knuckle of tube.
The knuckle of tube is released from the
If Silastic band sterilization
is desired by the two-incision technique, the second-incision
instrument is inserted as in Figure 18, under Laparoscopy Technique
and the Silastic band applicator is inserted through the second-incision
trocar into the lower abdomen.
The Fallopian tube is again located, and
the second-incision Silastic band applicator is used to draw
the Fallopian tube into the applicator and push the Silastic
band over a knuckle of Fallopian tube.
When the operation has been
completed, either by the one-incision or two-incision technique,
the pelvic area is thoroughly inspected to see that both tubes
are adequately banded and that there is no hemorrhage.
The instruments are withdrawn, and the incision
is closed with a single 3-0 synthetic absorbable suture.