ABSTRACT
One hundred and four puerperal applications have been performed using the (original) Weck pistol-grip applicator and applying the large Weck clip in the inverted V configuration. Follow-up varied from 37 to 42 months. The corrected failure rate was 8.7%. Mechanical difficulties were encountered with the jaws and metal sleeve of the (original) Weck pistol-grip applicator. Recovered clip configuration and tubal tissue histology are presented. Histologic changes suggest possible reversibility.
Subject(s)
Sterilization, Tubal/methods , Animals , Evaluation Studies as Topic , Female , Follow-Up Studies , Humans , Rabbits , Sterilization Reversal , Sterilization, Tubal/instrumentationABSTRACT
Forty-five puerperal inverted V Weck clip applications have been completed with either the Samuel's or (modified) Weck pistol-grip applicator. Of the 45 applications, 31 have been followed for 25 to 36 months (69%), 12 have been followed for 13 to 25 months (27%), and 2 have been followed for 9 to 12 months (4%). The failure rate thus far is 2.2%. No mechanical difficulties were encountered with the Samuel's or the (modified) Weck pistol-grip applicator. Reversibility has been observed in one interval patient, while pre-admission evaluation of a puerperal patient suggests postremoval tubal patency.
PIP: A 2ndary study was initiated following the completion of the 1st puerperal Weck clip sterilization study in April 1973. Patient motivation, minimal tubal anatomical distortion, either permanent or semipermanent fertility control, and reversibility continued as features in this study. 45 transabdominal inverted V applications were made in the immediate puerperal period, usually within 24 hours. Resident operative time was consistent with the 1st series. Routine postoperative hysterosalpingograms were not obtained for verification. The longest follow-up period was 36 months and the shortest was 9 months. Of the 45 cases, 31 (69%) were followed for 25-36 months; 12 (27%) were followed for 13-25 months; and 2 were followed from 9-12 months (4%). The failure rate of 2.2% represents 1 failure in the entire group of 45. No mechanical problems were encountered with the Samuel's or the (modified) Weck pistol-grip applicator. Reversibility was observed in 1 interval patient, whereas preadmission evaluation of a puerperal patient suggested postremoval tubal patency.
