In a minilaparotomy, a 2-inch incision is made in the abdomen. The surgeon, using special instruments, lifts the fallopian tubes and, using clips, a plastic ring, or an electric current, seals the tubes. Another method, laparoscopy, involves making a small incision above the navel, and distending the abdominal cavity so that the intestine separates from the uterus and fallopian tubes. Then a laparoscope--a miniaturized, flexible telescope--is used to visualize the fallopian tubes while closing them off.

Both of these methods are replacing the traditional laparotomy.

Major complications, which are rare in female sterilization, include: infection, hemorrhage, and problems associated with the use of general anesthesia. It is estimated that major complications occur in 1.7 percent of the cases, while the overall complication rate has been reported to be between 0.1 and 15.3 percent.

The failure rate of laparoscopy and minilaparotomy procedures, as well as vasectomy, is less than 1 percent. Although there has been some success in reopening the fallopian tubes or the vas deferens, the success rate is low, and sterilization should be considered irreversible.

Merle S. Goldberg, a writer in Washington, D. C, has also been involved in contraceptive services for women, both in the United States and developing countries, for the last 25 years.

BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE * FOOD AND DRUG ADMINISTRATION

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