Tubal ligation per vaginum -- with special reference to culdoscopic ligation.

A report of 523 interim tubal ligation sterilizations is presented. 170 of the operations were performed via the vaginal approach, 80 of which utilized the culdoscope. Contraindications to the vaginal approach are given. Complications and morbidity in the series were low. The immediate morbidity for culdoscopic sterilization was 3 times less than that of other procedures. 8 of 101 patients at follow-up had minor complications. The advantages of the vaginal approach for tubal ligation include greater acceptability to patients, shorter hospitalization, the nonessentiality of general anesthesia, and low rates of postoperative pain and morbidity.