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  • Title: [Laparoscopic sterilization with the Hulka-Clemens clip. Review of 215 cases (author's transl)].
    Author: Lecart C, Donnez J, D'Hulster W, Fagnart G.
    Journal: J Gynecol Obstet Biol Reprod (Paris); 1980; 9(2):253-9. PubMed ID: 7451899.
    Abstract:
    The application of a modified Hulka-Clemens spring loaded clip to each fallopian tube is a real progress in the fertility control. The operation is quick and easy to perform. The method avoids the dangers of hemorrhage and the complications encountered with other sterilization techniques. The authors give the results by 215 patients. One pregnancy has followed the sterilization procedure. The complications are infrequent in experienced hands. 215 women, 20-45 years of age, underwent tubal sterilization by laparoscopic application of the Hulka-Clemens clip. 123 operations (Series I) were performed in a gynecological ward and 92 cases (Series II) in a university clinic all under general anesthesia. In Series I, the 65 operation performed with a single incision took 10-15 minutes; the 58 performed with a double incision took 20-25 minutes. The double incision operations performed in series II took 20-45 minutes. A third clip was necessary in 14% of the operations in series I and in 26% in series II. 96% of the cases were without complication in series I (length of hospitalization 24-26 hours), compared to 80.4% in series II (length of hospitalization 48-50 hours). The majority of operative complications were lost clips (9 cases) and in 5 cases of series II, the large ligament was torn. 11.9% of the patients complained of post-opertive pelvic pain. There was 1 pregnancy, and there were 2 cases of tubal permeability. 4.6% of the patients reported menstrual problems, which were treated successfully with progestins.
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