With the advent of the laparoscope not long ago, this is now the simplest method. A small incision (about 1 cm in length) is made just beneath the navel. Then the laparoscope, a long tube with lights and special lenses at the far end, is inserted. This gives an excellent view of the pelvic cavity. The organs of reproduction are clearly visible.
Through another small incision, measuring about 0.5 cm near where an appendix operation incision is normally made, another device is inserted. This contains a hook with which the tube can be grasped. At the right moment, a special current is passed into the hook, and the tube is sealed off permanently with diathermy. The tube is then cut and each end becomes sealed as a permanent measure. Each incision requires about one suture.
Hospitalization is about one to two days, and the person can return to normal activities within a few days. It is an excellent method, and the results are invariably successful. It has largely replaced the major operation which involved a larger surgical incision, allowing the surgeon access to the pelvic cavity in which each tube was physically cut and tied. The results are identical with the former method, which is now largely taking over with most gynaecologists. Variations of the method are used by some others, referred to as a culdoscopy, in which a similar operation is carried out via the upper vaginal walls.
Although the success rate with laparoscopic diathermy is very high, many women experience complications a few years later, mainly heavy menstrual bleeding. As a result, many doctors now use metal clips to close the tubes, placing two on each tube. At present these seem to be more popular than the diathermy method. It is done with the laparoscope.
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