Tubal Sterilization by Electrosurgical Methods
If electrons from an electrosurgical generator are concentrated in one location, heat within the tissue increases sharply and desiccates the tissue until resistance is so high that no
The monopolar electrosurgical technique is straightforward.
The dip offers a chance for reanastomosis, more so than electrosurgical methods; however, a sterilization procedure should only be undertaken if the patient understands and agrees to its permanence.
Peritoneal implants of endometriosis may be ablated with bipolar electrosurgical instruments or excised by sharp dissection.5,11 A Cochrane review including seven randomized controlled trials compared different laparoscopic surgical methods (including excisional vs. ablative techniques) with diagnostic laparoscopy and found thal pain improved with operative laparoscopy compared to diagnostic laparoscopy alone-by 100%, 70%, and 40% in women with moderate, mild, and minimal endometriosis, respectively.511 In comparing excision versus ablation for surgical management of endometriosis, there was no dear superiority of one method over another.''11 However, those favoring excision over ablation emphasize that because the depths of disease and ablation cannot be determined, the risk that treatment may he inadequate is greater when disease is ablated rather than excised.
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