What it is
The Hulka Clip is a spring-loaded tubal occlusion device that a surgeon applies across each fallopian tube during laparoscopic sterilization. It has plastic jaws held together by a metal spring. The spring pressure crushes and occludes the tube. Richard Wolf Medical Instruments manufactures it, and the FDA approved it through the premarket approval process in September 1996 (P870080).
How well it works
The Hulka Clip is effective but has a higher failure rate than the Filshie Clip. In a randomized trial of 2126 women comparing the two clips, the 24-month life-table pregnancy probability was 28.1 per 1000 for Hulka versus 9.7 per 1000 for Filshie (PMID 11137070). An earlier study of 544 women reported a 1.83% failure rate for the Hulka Clip (PMID 12337683). The procedure is permanent and intended for people who do not want future pregnancies.
Where to get it
A gynecologist or general surgeon performs the procedure in an operating room under general or regional anesthesia. They insert the clips through small laparoscopic incisions. Insurance in the United States must cover sterilization at no cost under the Affordable Care Act. Because the Filshie Clip has lower failure rates in comparative studies, some surgeons prefer it over the Hulka Clip. Your surgeon’s training and preference usually determine which method they use.