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Coagulation Methods of Tubal Ligation
Bipolar Tubal Coagulation
Bipolar tubal coagulation is a very popular method of laparoscopic female sterilization in the United States. With this method of tubal ligation, the fallopian tube is grasped between two poles of electrical conducting forceps, and electrical current passes through the tube between the two ends of the forceps. Damage to the tube is limited to the segment between the forceps. Often, two or three adjacent sites are coagulated resulting in loss of approximately 2-5 cm of fallopian tube. Bipolar tubal coagulation is a good method of female sterilization for women who decide to have a tubal reversal procedure. Pregnancy rates after reversal of bipolar tubal coagulation are approximately 60% but can be much lower if much of the tube has been damaged. Patients having the tubal coagulation procedure often choose IVF instead of tubal reversals because of the lower success rate. If multiple sites have undergone coagulation, screening laparoscopy is recommended to evaluate the tubal lengths remaining for repair.
Bipolar Tubal Ligation Method
Monopolar Tubal Coagulation
Monopolar coagulation of the fallopian tubes is less common than bipolar
coagulation tubal ligation. The electrical current spreads outward from the
coagulating forceps, so monopolar coagulation damages more of the fallopian
tube than bipolar coagulation. In most cases, the tube is also cut after it
has been coagulated.
When a single site of the tube has been coagulated and divided, tubal
reversal can be performed without the need for further diagnostic tests. If
multiple sites have undergone monopolar coagulation, screening laparoscopy
is recommended to evaluate the tubal lengths remaining for repair. Pregnancy
rates after reversal of monopolar coagulation procedures are 40-50%.
Monopolar Tubal Ligation Method