Tubal sterilization: Complications of laparoscopy and minilaparotomy

ObjectiveTo evaluate whether intra- and post-operative morbidity varies according to the method used for female sterilization.Study designThe database of the Swiss obstetric study group was analyzed for a period of 9 years. After the exclusion of cases with extraneous factors that may have influenced the operative outcome, three groups of patients were identified: (1) interval laparoscopic sterilization unrelated to pregnancy (n = 20,325); (2) postpartum laparoscopic sterilization (n = 2233); (3) postpartum sterilization by minilaparotomy (n = 5095). Intra-operative and post-operative complications were compared according to the surgical approach.ResultsA total of 27,653 patients were included in the study. The proportion of major complications was higher in group 3 than in group 1 (0.39% versus 0.10%, odds ratio 4.0, 95% CI 2.15–7.44, p < 0.001) but not statistically different between groups 1 (0.10%) and 2 (0.18%). Minor complications were statistically significantly more frequent in group 3 (0.82%) than in group 1 (0.26%) or group 2 (0.27%). There was no case of intra-operative or post-operative death in the study population.ConclusionWhen available, a laparoscopic approach should be chosen for female sterilization. After uneventful pregnancy course and delivery, it does not seem justified to delay the endoscopic sterilization to a later time.