What it is
The Filshie Clip is a titanium clip with a silicone rubber lining that a surgeon applies across each fallopian tube during laparoscopic sterilization. The clip crushes and occludes the tube, blocking sperm from reaching eggs. Femcare, a UK-based medical device company, manufactures it. The FDA approved it through the premarket approval (PMA) process in September 1996 (P920046), and it remains actively marketed.
How well it works
The Filshie Clip has the lowest failure rate among tubal occlusion clips. A 10-year follow-up study found a cumulative pregnancy rate of 9.8 per 1000 women including self-reported pregnancies, or 2.8 per 1000 for verified pregnancies (DOI 10.1089/whr.2021.0017). An Australian study of 30,000 procedures reported a failure rate of 2 to 3 per 1000 operations. A randomized trial comparing Filshie clips to Hulka clips in 2126 women found 12-month pregnancy probabilities of 1.1 per 1000 for Filshie versus 6.9 per 1000 for Hulka (PMID 11137070). 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. The Filshie Clip is one of several tubal occlusion methods; others include the Hulka clip, Falope-Ring, and bipolar cauterization. Your surgeon’s training and preference usually determine which method they use.