Hysteroscopic sterilization widens patient options. (Rapid Patient Recovery).

BIG SKY, MONT. -- Hysteroscopic sterilization is a new and appealing option for selected women seeking. sterilization, Dr. Eric Bieber said at a meeting on gynecology, gynecologic oncology, and reproductive endocrinology.

Hysteroscopic sterilization is an attractive option as the only form of sterilization now available that does not require general anesthesia or incisional surgery. Because of this, patient recovery is rapid, said Dr. Bieber, chairman of the division of ob.gyn. at Geisinger Health System in Danville, Pa.

The microinserts, which are placed hysteroscopically in the fallopian tubes, were approved by the Food and Drug Administration late last year and are marketed as the Essure System. Dr. Bieber said that he does not have a financial relationship with Conceptus, the company that markets Essure.

During the insertion procedure, the delivery catheter crosses the cervix and uterus and the coils are placed across the uterotubal junction. The coil's design allows it to anchor in place and fill the space to block the tubal lumen. The fallopian tubes eventually completely occlude when tissue grows into and around the microinsert.

The procedure should not be done on women who are uncertain about their desire to end fertility, those in whom only one microinsert can be placed (two are needed, one for each fallopian tube), women who have already undergone a tubal ligation, women who are or may be pregnant, and those who have an active or recent pelvic infection, Dr. Bieber said at the meeting, which was sponsored by the University of Chicago.

The pivotal trial that led to FDA approval involved 518 women at a total of 13 sites in the United States, Europe, and Australia.

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