Filshie clip favored over Pomeroy technique in study.(Ten Surgeons Surveyed)

LA JOLLA, CALIF. -- Surgeons strongly preferred the Filshie clip technique to the Pomeroy technique for obstetric sterilization in a small pilot study.

If the results are replicated in larger trials, the Filshie dip, a titanium-silicone device used for tubal occlusion with laparoscopic and minilaparotomy applicators, "has the potential to establish a new standard of care for postpartum and intrapartum cesarean sterilization," Dr. Bettina Kohaut said at the annual meeting of the Association of Reproductive Health Professionals.

More than 350,000 obstetric sterilization procedures are performed following vaginal or cesarean delivery in the United States each year, primarily with the Pomeroy technique of tubal ligation and removal of a portion of the fallopian tube.

Studies conducted in Europe, Asia, and Latin America support the safety and efficacy of the Filshie clip technique for obstetric sterilization, but no reports have been published describing the use of the technique in the United States, said Dr. Kohaut, a fourth-year ob.gyn, resident at the University of Florida Health Science Center, Jacksonville.

The Filshie clip, invented by British ob. gyn. Dr. Marcus Filshie, received Food and Drug Administration approval in 1996 for interval and obstetric sterilization use.

The Pomeroy technique involves ligating the isthmic portion of the tube with a 2-0 plain gut suture and resecting the knuckled portion. Potential disadvantages include the need for tubal exteriorization and the potential for mesosalpingeal hemorrhage, Dr. Kohaut said.

The ...