of Tubal Patency
Division via Laparoscopy
Modified Irving Technique
Sterilization - Ucheda Technique
of the Fallopian Tube
of the Ovary
of the Ovary
Control of Hemorrhage
Hemorrhage secondary to laparoscopic procedures, particularly tubal
sterilization, can frequently be controlled via the laparoscope with
electrocoagulation and/or Silastic banding of the bleeding points.
The purpose of this operation is to control bleeding.
Physiologic Changes. Pelvic
hemorrhage is controlled.
Points of Caution. If
bleeding occurs adjacent to a vital structure, the Silastic band
technique is preferred over the electrocoagulation technique. The
electrocoagulation technique is adequate, however, for control of
hemorrhage on the Fallopian tube.
Care must be taken to ensure that
hemorrhage is controlled prior to withdrawing the instruments from
In most instances when the surgeon is using
either electrocoagulation or the Silastic band technique, hemorrhage
can be controlled without laparotomy. The bleeding areas are
identified through the laparoscope.
The laparoscopy grasping tongs of the Silastic
band instrument are used to grasp the bleeding area to draw it
into the Silastic band applier and to push a Silastic band over
the bleeding pedicles. This band acts as a suture ligature and
stops the bleeding. Two or more such bands can be applied to
all bleeding areas.
If the surgeon prefers electrocoagulation
for control of hemorrhage, the 3-mm grasping forceps is used
to electrocoagulate the bleeding stumps of the proximal or distal
After electrocoagulation or
application of a Silastic band, the area should be irrigated
with a small amount of sterile saline solution and observed for
several minutes to be sure that all bleeding has stopped.