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Puerperal sterilization with Silastic band technique.

A recently introduced surgical technique for interval tubal ligation was evaluated for use in puerperium as part of the effort to find a method of female sterilization that is competitive with vasectomy in speed cost effectiveness and simplicity. The Silastic ring (Falope Ring) was applied to the fallopian tubes through a conventional minilaparotomy incision. Patients scheduled for elective puerperal tubal ligation during the 6 months of the study period were asked to participate in the evaluation. Each participant was randomly assigned to the study group. The assignment was revealed to the operating surgeon just before entering the operating room. All tubal ligations were performed within 48 hours of delivery. Epidural spinal and general anesthesia were used. In the study patients the tubes were identified and delivered into the transverse infraumbilical incision and the Falope applicator. The choice of the manual sterilization technique in the control group was left to the discretion of the operating surgeon. The mean age parity interval after the delivery and hospital stay were not statistically different in the 2 groups. The mean time required to perform the ring application was significantly shorter than the time needed for manual tubal ligation. In all but 1 patient the application was easy without any difficulties in retracting the tube into the cylinder bleeding or danger of devering the dilated panpiniform plexus. On the basis of this limited series the Silastic band technique appears to be simple and feasible for postpartum tubal ligation.