Pomeroy technique

Named after Dr. Ralph Pomeroy, Pomeroy technique is a process of tubal ligation i.e. removal of a portion of the fallopian tube. It is a sterilization procedure for women devised by Dr. Ralph Pomeroy at the end of the 19th century and start of the 20th century. This procedure is still popular as it is an effective yet simple method to block the fallopian tubes.

The Pomeroy Technique

The technique adopts a simple yet effective procedure for tubal legation.

• In this technique, part of the tube (proximal portion of the tubal ampulla) is elevated so as to create a loop or a knuckle.
  
• An absorbable ligature (suture material) is tied around the base of the elevated part, and the tubal segment is cut out.
  
• Within a few days, the peritoneum, i.e. tissue that lines the organs of the abdominal cavity, grows and covers the severed ends of the tubal section.
  
• As the ligature dissolves, the severed ends of the fallopian tube separate from one another.
  
• The fallopian tubes remain separate without reattaching because of the above mentioned separation and the peritoneal covering.
  
• Eggs cannot travel down the separated fallopian tube, and so the woman does not get pregnant.

Variations of the technique include the following. These variations determine the length of the tubal segment that can be repaired from the remaining tube.

• Length of the tube that is tied up and cut.
  
• Location of the tube where it is going to be tied and cut.
  
• Number of ligatures placed around the tube.
  
• Type of ligatures placed around the tube.
  
• If the cut ends are crushed or coagulated.

There are many advantages of the modified Pomeroy technique. In rare cases, the severed ends drift back together and heal, or the suture does not dissolve and the fallopian tube becomes connected again.

The Pomeroy procedure is:

• Simple to perform
  
• Highly effective depending on the length of the tube removed
  
• Pomeroy ligation technique leaves two healthy segments of the fallopian tube which can be rejoined, if required through a tubal legation reversal surgery.
  
• Successful reversal rates are quite high; about two thirds of the women become pregnant following reversal of this procedure.
  
• Prior to tube reversal, the length of the tube that has been removed can be determined from the tube legation report.
  
• Procedure can be performed vaginally, abdominally or through laparoscope.
  
• Minimal complications.