Fifty patients have been sterilized laparoscopically using a plastic tubal (Bleier) clip having a "snap-shut" mechanism. Initial assessment indicates that the method is simple in principle but there are limitations, including the bulky dimensions of the applicator, absence of a safety-catch mechanism, and faults in the clip design. Modifications are indicated before further evaluation.
PIP: The use of a plastic tubal (Bleier) clip with a "snap-shut" mechanism in the laparoscopic sterilization of 50 patients was assessed. Generally, the patients were admitted the day prior to the procedure and discharged the day after. After fulfilling the prerequisites for laparoscopy, the applicator loaded with the 1st clip was passed through the cannula inserted in the midline suprapubically. The attempt was made to apply the clip across the tube 2-3 cm lateral to the cornu. Then the applicator was withdrawn, reloaded, and another clip was applied on the remaining tube. Subcuticular Dexon was used to suture the incisions after decompression of the abdomen. Although the initial assessment reveals that the method is simple in principle, limitations exist. These include the bulky dimensions of the applicator, absence of a safety-catch mechanism, and faults in the clip design. Modifications are necessary before further evaluation.