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How To Make Sure You Don't Need To Claim For Failed Sterilisation

View profile for Sylvia Taylor
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Until recently failed sterilisation was responsible for more litigation than any other gynaecological procedure.  Although this is no longer the case, claims for failed sterilisation are still not uncommon.

There are various options open to women who require to be sterilised which include:-


(a)       laparoscopic surgery involving either diathermy coagulation of part of the fallopian tube or the application of falope rings or filshie clips and


(b)       sterilisation during open surgery which is normally performed at the same time as a caesarean section;

Very few surgeons use diathermy coagulation since this not only has a high failure rate but also risks damaging surrounding organs. 

In a number of cases in which we have been involved the surgeon has failed to ensure that the clip was applied to the appropriate part of the fallopian tube, where it is narrow, so that the clip completely occludes the lumen.  In an attempt to reduce the failure rate some surgeons apply two clips to each fallopian tube.  However on occasions a few surgeons have mistaken the neighbouring round ligaments for the fallopian tubes and have attached the clips to those ligaments rather than the fallopian tube.

Whatever method of sterilisation is used, a properly performed operation can still fail. This could be due to the two halves of the divided fallopian tube coming together and re-joining (re-canalisation) or a tuboperitoneal fistula may form in the proximal segment. 

It is often difficult to establish whether the failed sterilisation is due to the negligence of the surgeon.  Often the only way to establish this is for the women to undergo further surgery.  However, it is generally accepted that where the sterilisation failed at an early date, it is more likely that the failure will be negligent rather than non-negligent. 

Prior to undergoing a sterilisation procedure women should be warned that the procedure should be regarded as irreversible. It is therefore also necessary to warn them of the failure rate of such procedures and to explain the alternative methods available to them. In particular the Mirena coil offers an equally effective and indeed safer alternative to laparoscopic sterilisation. 

Another alternative is hysteroscopic sterilisation where a coil is inserted into each fallopian tube via the vagina and cervix.  The coil consists of metal and polyester fibres which induce scar tissue formation and subsequent occlusion of the tubes.  It is necessary to continue to use contraception for a period of 3 months following insertion of the device.

Speak to us if you are worried about the success of your sterilisation procedure.