CSIG Interactive Session - Standard Laparoscopic Tubal Ligation vs. Bilateral Salpingectomy for Both Tubal Ligation and Cancer Prevention

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Presented by the Contraception Special Interest Group

Standard Laparoscopic Tubal Ligation vs. Bilateral Salpingectomy for Both Tubal Ligation and Cancer Prevention: An Interactive Debate

Needs Assessment and Description
Contraception is an important and relevant topic to members of the American Society for Reproductive Medicine (ASRM). A review of the literature suggests that tubectomy may reduce the risk of ovarian cancer. Since the topic of contraception intersects with gynecology, oncology and family planning, this live course for clinicians in these fields will provide a highly interactive debate on the issue of recommending tubectomy over other tubal sterilization techniques.

Learning Objectives
At the conclusion of this session, participants should be able to: 

1. Discuss the data on tubectomy and ovarian cancer prevention. 
2. Compare the expected surgical risks and outcomes of laparoscopic tubectomy vs. tubal occlusion techniques including when these are performed postpartum. 
3. Discuss differences between the laparoscopic and hysteroscopic approaches to sterilization. 
4. Critique the literature on long-term strategies for ovarian cancer risk reduction. 
5. Summarize the effects of tubectomy on ovarian function and premature ovarian failure.

ACGME Competency
Patient Care

TEST QUESTION:
A 40-year-old nulligravid woman presents for discussion about long-term contraception. After participating in this session, in my practice I will tell this woman that: 

1. Data from well-designed randomized controlled trials suggests that hysteroscopic tubal occlusion has a higher effectiveness than use of a hormonal intrauterine system. 
2. Use of combined oral contraceptives increases the risk of breast and endometrial cancer. 
3. The use of the levonorgestrel intrauterine system does not increase the risk of breast cancer and lowers the risk of endometrial cancer. 
4. Removal of the fallopian tubes is an effective, permanent method of contraception with no greater risks than standard tubal occlusion techniques at laparoscopy. 
5. Not applicable to my area of practice.