of Tubal Patency
Division via Laparoscopy
Modified Irving Technique
Sterilization - Ucheda Technique
of the Fallopian Tube
of the Ovary
of the Ovary
Hulka Clip Sterilization
Laparoscopic Hulka clip application for female sterilization
differs from the other methods of laparoscopy sterilization in that
it applies a spring-loaded Silastic clip to the Fallopian tube. It
has the advantage of producing the least tissue damage to the Fallopian
tube and, therefore, may prove to be the most reversible form of female
sterilization. The laparoscopic technique is the same as previously
described for other laparoscopic procedures.
The purpose of the operation
is to effect female sterilization.
Physiologic Changes. The oocyte and spermatozoa are
prevented from meeting in the midportion of the Fallopian tube.
Points of Caution. Care must be taken to ensure that
the Hulka clip is over the entire Fallopian tube and that the tips
of the clip grasp a small portion of mesosalpinx.
With a loaded clip applier next to the Fallopian
tube, 2-3 mL of 1% Xylocaine solution are pushed through the
clip applier and sprayed on the Fallopian tube for local anesthesia.
The surgeon opens the clip by activating
the shaft retractor at the end of the clip applier. The same
mechanism is used to close the clip and lock it into position
with its metallic spring.
The clip has been applied to the Fallopian
tube. It is released from the clip applier when the surgeon withdraws
the shaft to the extreme position.
The same procedure is performed
on the opposite tube. The surgical instruments are withdrawn,
and the gas is released through the remaining trocar sleeve.
The incision is closed with single 3-0 synthetic absorbable suture.