***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To assess the safety , effectiveness , and reliability of a tubal occlusion microinsert for permanent contraception , as well as to document patient recovery from the placement procedure and overall patient satisfaction . METHODS A cohort of 518 previously fertile women seeking sterilization participated in this prospect i ve , phase III , international , multicenter trial . Microinsert placement was attempted in 507 women .  Microinserts were placed bilaterally into the proximal fallopian tube lumens under hysteroscopic visualization in outpatient procedures . RESULTS Bilateral placement of the microinsert was achieved in 464 ( 92 % ) of 507 women . The most common reasons for failure to achieve satisfactory placement were tubal obstruction and stenosis or difficult access to the proximal tubal lumen . More than half of the women rated the average pain during the procedure as either mild or none , and 88 % rated tolerance of device placement procedure as good to excellent . Average time to discharge was 80 minutes . Sixty percent of women returned to normal function within 1 day or less , and 92 % missed 1 day or less of work . Three months after placement , correct microinsert placement and tubal occlusion were confirmed in 96 % and 92 % of cases , respectively . Comfort was rated as good to excellent by 99 % of women at all follow-up visits . Ultimately , 449 of 518 women ( 87 % ) could rely on the microinsert for permanent contraception . After 9620 woman-months of exposure to intercourse , no pregnancies have been recorded . CONCLUSION This study demonstrates that hysteroscopic interval tubal sterilization with microinserts is well tolerated and results in rapid recovery , high patient satisfaction , and effective permanent contraception The use of multiple clips for the occlusion of the Fallopian tubes has been reported in interval laparoscopic sterilization , but the circumstances leading to the performance of the multiple-clip procedure and its effects on safety and efficacy have not been carefully studied . A data set from international multi-center clinical trials of Filshie clips and Wolf ( Hulka ) clips was used to examine the possible reasons for performing this procedure for 102 women . Their complications , complaints , and surgical and post-surgical events before discharge and during one month of follow-up were compared with those of the 408 women whose tubes were occluded by single clip .  Results indicate that multiple clips were most often used when surgical difficulties ( and to a much lesser degree , tubal and /or mesosalpingeal injury ) were encountered during the sterilization procedure . No increased risk of short-term complications or complaints ( including pelvic pain ) was found at one-month follow-up for those patients who received multiple clips 
    Output:
    
REVIEW ER 'S CONCLUSIONS Electrocoagulation was associated with less morbidity when compared with tubal ring and other methods .
However the risk of burns to the small bowel might be a serious criticism of the approach .