A. The bottom jaw of the clip should be clearly visualized in the mesosalpinx prior to closure of the device.
B. The clip should not transect or tear the tube, as this will increase the chance of the tubal lumen regenerating.
C. If the first clip is not applied at 90 degrees or is not at the proper distance from the uterus, a second clip can be applied to the same tube.
D. All of the above.
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Correct Answer » D
Explanation
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The Filshie clip is a hinged device made of titanium lined with silicone rubber. After the fallopian tube has been identified, the Filshie clip is brought to an area of tube 2–3 cm distal to the uterotubal junction. The lower edge of the clip is then visualized through the mesosalpinx to confirm that, when closed, the clip will completely occlude the tubal lumen. The clip is then closed via the applicator, and when closed flattens the curved upper jaw of the clip, occluding the tube. The upper jaw of the clip has a leading edge that extends under the lip of the lower jaw. As necrosis occurs, the rubber expands to keep the lumen blocked. Over time the tube divides into two separate peritoneum-covered stumps.
Unique to the Filshie clip, there are several points to remember:
- The clip should be applied at a 90 degree angle, perpendicular to the lumen of the tube.
- The bottom jaw of the Filshie clip should be clearly visualized in the mesosalpinx prior to closure of the device.
- The clip should not transect or tear the tube, as this will increase the chance of the tubal lumen regenerating.
- If the first clip is not applied at 90 degrees or is not at the proper distance from the uterus, a second clip can be applied to the same tube.”
