What is the Pomeroy procedure for laparoscopic tubal ligation?

Updated: Apr 03, 2018
  • Author: Jessica L Versage, MD; Chief Editor: Christine Isaacs, MD  more...
  • Print
Answer

The Pomeroy procedure began being performed with the laparoscope in the late 1990s. It is also referred to as a partial salpingectomy.

A 10-mm operating laparoscope with an accessory trocar port or a 5-mm laparoscope with two lateral 5-mm ports is needed. Two laparoscopic slip knots may be used for this procedure.

When using the Endoloop, insert it through a lateral port. Then, place the loop of suture over the isthmic portion of the fallopian tube. Laparoscopic graspers are then used to gently bring a loop of the fallopian tube through the Endoloop. Make sure a minimum of 1 cm of fallopian tube is brought through. The extraabdominal plastic end of the Endoloop is cracked, and the suture is pulled to tighten the knot. The plastic sheath is then removed.

The other laparoscopic slip knot is a plain-gut Roeder knot. This is introduced through a lateral port and placed over the isthmic portion of the fallopian tube. A grasper is used to pull a loop of the fallopian tube through the knot, and the knot is then tightened down.

For both techniques, laparoscopic scissors are used to cut the suture. The looped portion of the fallopian tube is excised with the laparoscopic scissors. At minimum, a 1-cm segment should be removed to decrease the failure rate. The excised tubal segments may be sent to pathology.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!