Document Detail


Deaths associated with laparoscopic sterilization by unipolar electrocoagulating devices, 1978 and 1979.
MedLine Citation:
PMID:  6450536     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In 1978 and 1979, two women in the United States were reported to have died from electrical complications following sterilization with unipolar coagulating devices. Both deaths followed apparent bowel injuries occurring at the time of sterilization. Numerous reports have documented the electrical accidents associated with unipolar electrocoagulation. Because unipolar electrocoagulation has greater risk for these complications than alternative sterilization techniques, without proved greater benefits, we question the need for continuing its use in female sterilization.
Most of the laparoscopy procedures performed in the U. S. use electric current to coagulate the fallopian tubes. Most of the coagulations are done with unipolar devices, with its attendant risks of accidental burns to the patient and the operator. In the years 1978 and 1979, 2 sterilization-related deaths were recorded by the Center for Disease Control, apparently resulting form inadvertent burns to the bowel sustained during sterilization with unipolar devices. The 1st case involved a 41-year old woman, gravida 6, para 5, abortus 1 who underwent a laparoscopic tubal sterilization via electrocoagulation with a unipolar device. 23 days after the operation, she returned to the hospital complaining of abdominal pain and evidence of peritonitis. Laparotomy was performed, but her condition deteriorated. She died 41 days after the laparotomy. Autopsy revealed bowel perforation with subcutaneous abscess. The 2nd case involved a healthy 22-year old woman, gravida 4, para 4 who underwent a similar sterilization procedure. She presented to the hospital 7 days after the operation complaining of abdominal pain. Laparotomy was also performed but she died two days later of septic shock. Bowel perforation was strongly suspected, although the perforation site was never located. Bipolar coagulation may reduce the risk of electric accidents. The need for continuing the use of unipolar electrocoagulation, in the light of risk of death, is questioned.
Authors:
H B Peterson; H W Ory; J R Greenspan; C W Tyler
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  139     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1981 Jan 
Date Detail:
Created Date:  1981-03-17     Completed Date:  1981-03-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  141-3     Citation Subset:  AIM; IM; J    
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MeSH Terms
Descriptor/Qualifier:
Adult
Burns, Electric / etiology,  mortality
Colon / injuries*
Electrocoagulation / methods,  mortality*
Female
Humans
Laparoscopy / mortality*
Peritonitis / etiology
Sterilization, Tubal / methods,  mortality*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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