From the Guidelines
The isthmic portion of the fallopian tube is the level targeted in the Pomeroy method of tubal ligation. This procedure involves identifying the mid-portion of the fallopian tube, creating a loop of the isthmic segment, ligating the base of the loop with absorbable suture material, and then excising the loop of tube above the ligature. The isthmic portion is specifically chosen because it is the narrowest segment of the fallopian tube, making it easier to create a complete occlusion. Additionally, this segment has less vascularity compared to the ampullary region, which reduces the risk of bleeding during the procedure. The use of absorbable suture material allows the ligated ends to separate as the suture dissolves, creating a gap between the cut ends that prevents recanalization and ensures permanent sterilization.
This technique is commonly performed during cesarean sections or as an interval procedure and has a high efficacy rate with failure rates typically less than 1% 1. Although the provided evidence does not directly discuss the Pomeroy method, the general principles of tubal ligation are relevant, and the isthmic portion is the preferred site for occlusion due to its anatomical characteristics. In contrast, other methods like vasectomy are also effective for permanent contraception, but the question specifically asks about the Pomeroy method of tubal ligation 1.
Key points to consider in the Pomeroy method include:
- The isthmic portion is the narrowest segment of the fallopian tube
- Less vascularity in the isthmic portion reduces the risk of bleeding
- Absorbable suture material is used to allow for separation of the ligated ends and prevent recanalization
- The procedure has a high efficacy rate with low failure rates
- It can be performed during cesarean sections or as an interval procedure.
From the Research
Pomeroy Method for Fallopian Tube Ligation
- The Pomeroy method is a widely-used technique for surgical female sterilization, involving the removal of a small segment of the fallopian tube [ 2 ].
- The level of the fallopian tube at which the Pomeroy method is performed is typically at the mid-isthmic or ampullary portion of the tube [ 3 ].
- The procedure involves creating a loop in the fallopian tube using a suture or clip, and then removing a small segment of the tube [ 4 ].
- The Pomeroy method can be performed laparoscopically, using endoloop sutures or other techniques, and has been shown to be safe and effective [ 5 ].
- The ideal length of the tubal segment to be removed is at least 1 cm to minimize the risk of sterilization failure [ 5 ].