What is the Falope ring technique for laparoscopic tubal ligation?

Updated: Apr 03, 2018
  • Author: Jessica L Versage, MD; Chief Editor: Christine Isaacs, MD  more...
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This nonthermal method was introduced by Yoon and colleagues in 1975. [41] The technique uses a 3.6-mm silicone band, with an inner diameter of 1 mm, to cause ischemia and necrosis of approximately 2 cm of the isthmic portion of the fallopian tube. There is barium sulfate in the ring to make it visible on radiography.

Correct placement is important because it takes a few days for full necrosis to occur, and early slippage of the ring may lead to failure. The applicator device used to apply the Falope ring can be used through the 10-mm operating laparoscope or an accessory 7-mm trocar.

Immediately prior to placing the instrument in the port, stretch the band over the ends of the applicator barrel around the smaller sheath, ensuring the ring is not defective. Next, introduce the applicator device into the abdomen and open up the grasping prongs so they are outside of the sheath.

Place one of the prongs on either side beneath the isthmic portion of the fallopian tube so it is in the mesosalpinx, about 3 cm away from the uterine cornu. Gently pull the prongs into the applicator and ensure that they close around the tube as they are being pulled into the sheath; approximately 1.5–2.5 cm of the tube will be pulled in.

It is useful to push the applicator toward the tube at the same time to ensure that there is not too much tension on the fallopian tube. The larger sheath will push the Falope ring over the loop of the tube grasped by the prongs; the ring will then constrict back to its original size.

It is important to perform this last step slowly and not to place too much traction on the fallopian tube. Otherwise, the band can come off completely, encompass only the serosal portion of the tube, cause laceration of the fallopian tube and subsequent bleeding, or cause a complete transection of the tube. If a complete transaction occurs, separate rings may be placed around both ends of the tube, or cauterization may be used.

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