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Tubal Ligation Sterilization Causing Intestine Perforation

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October 25, 2015
Laparoscopic tubal ligation surgery is performed through a narrow pipe inserted into the abdomen. Either a clip is placed across each fallopian tube, or it is cauterized (burned by the passage of electricity through a segment of each tube, causing it to char and seal).

Decades ago the electrocautery was of the “unipolar” design. This allowed the electricity to enter through the active electrode, while the current returned to the device through the body, and then via a ground electrode under the thigh. Unfortunately, the electric current had the risk of arcing into the nearby small intestine, burning a hole into this hollow organ.

That would result in its leakage causing peritonitis (intra-abdominal infection) requiring emergency surgery.

The modern devices are called “bipolar” because the electric current flows only between each side of the pliars-like grasping instrument. Intestinal burns should never occur. If that happens, it is either from the surgeon negligently touching the metal end to the intestine, or the electrocautery was defective and not properly maintained by the hospital.