Female sterilisation is responsible for more litigation than any other single surgical procedure either because of defective consent or because the operation was unsuccessful. Nowadays the vast majority of sterilisations are performed using a laparoscope (key-hole surgery). The most usual laparoscopic techniques are –
- Application of clips (Hulka-Clements or Filshie)
- Application of silastic rings (Falope)
- Diathermy coagulation (using heat to cut the tubes) – although this is becoming less common because of high failure rate.
In the past many sterilisations were performed via a laparotomy (opening of the abdomen) and the most popular and successful was the Pomeroy technique. This involved drawing the tube up into a loop and then tying off the base with catgut. The loop was then cut off. This method is still sometimes carried out using a laparoscope and is usually highly effective.
Surgical mistakes are more likely to occur with the closed laparoscopic method than with the abdomen open at laparotomy, particularly in the hands of an inexperienced surgeon, and it is not uncommon for the round ligaments in the pelvis to be mistaken for the Fallopian tubes.
When clips are used it is most important that they are applied to the narrowest part to the tube (the isthmus) If they are applied to the wider part they may not completely occlude the tube. Nowadays most surgeons apply 2 clips to each tube in an attempt to reduce failure rates.
However, whatever method of sterilisation is used, and however expertly it is performed, operations can still sometimes fail. The two main reasons for this are –
- The 2 halves of the divided Fallopian tube can come together and rejoin (recanalisation)
- The formation of a fistula (an abnormal passage) between the tube and the peritoneum (lining of the abdominal cavity).This happens most commonly with diathermy coagulation.
Female sterilisation is not a fool- proof method of contraception and all women undergoing the procedure should be warned of possible failure.
In cases where a woman becomes pregnant relatively shortly after the operation (in less than 12 months) it has been suggested that this is more likely to be due to surgical error than simply "one of those things".
JMW Medical Negligence Solicitors offer free advice on clinical and medical negligence claims, whether you have a good case and how much your compensation might be worth. We are able to deal with cases using legal aid or the no win no fee scheme in appropriate cases.
We have successfully won cases for a number of women who have become pregnant after a failed sterilisation operation.
For an assessment of your potential claim, please click here to complete our online enquiry form and one of our specialists will contact you shortly or please contact us on 0845 402 0001.
