First, what is a Tubal Ligation Procedure?
For women who no longer want children, sterilization by laparoscopy provides a safe and convenient form of contraception. Once completed, no further steps are needed to prevent pregnancy. During a tubal sterilization, the Fallopian tubes are cut or blocked, which prevents pregnancy by blocking the egg’s path to the sperm and uterus. This procedure is also called “tube tying.” Tubal ligation does not change a woman’s menstrual cycle or cause menopause.
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Types of Tubal Ligation
Laparoscopic Tubal Ligation
Laparoscopy makes it possible to see and do the surgery through small incisions in the abdomen in which the surgeon inserts a laparoscope. The laparoscope has a lens that magnifies what the surgeon is viewing. The instrument that the surgeon uses to cut (ligate) the tubes may be inserted alongside the laparoscope or through the incision just above the pubic hair.
Selective Excision of Tubal Ends
Closing Off The Ovaries
This procedure is performed under general anesthesia, takes about 30 minutes to perform, and typically go home the same day. During the procedure, a small incision is made in the navel and abdomen. A laparoscope is inserted through an incision and the Fallopian tubes are cut, tied, clamped, or sealed. Studies show that many types of ovarian cancers originate in the Fallopian tubes. By closing off access to the ovaries from the tubes by selective excision, the risk is reduced. This is a permanent procedure and careful consideration is necessary before consenting to the surgery.
How to prepare
To prepare for your Tubal Ligation Procedure, our OB/GYN Specialist will discuss the reasons in which you want this procedure done or why you should consider having it done.
What else may be discussed?
- The risks
- The benefits
- What happens during the procedure
- Preventing STI’s
- When you should have the procedure done
The procedure can be done at different recommended situations.
When can the procedure be done?
- If you are having a vaginal birth and no longer want kids, this procedure can be done immediately after the birth.
- If you are planning to have a c-section, the procedure can be done at this time.
- This procedure can also be done on an outpatient basis under general anesthesia. This is referred to as interval tubal ligation.
If you want to have this procedure done outside of your postpartum period, it is referred to as Interval sterilization. This is defined as six weeks after birth, but in reality, postpartum sterilization procedures are typically performed within 48 hours of delivery. (UpToDate.com)
What to Expect Before, During and After the Procedure
Before the procedure, you may be asked to take a pregnancy test to ensure you are not expecting.
Laparoscopy – In current practice, laparoscopy is the surgical approach used in the majority of patients who undergo interval sterilization. Laparoscopic methods typically include the placement of clips or rings on the tubes, electrosurgery, or salpingectomy. (See “Laparoscopic female sterilization”, section on ‘Tubal occlusion techniques’.)
•Mini-laparotomy – This approach may be used for interval sterilization, particularly in developing countries. (See “Postpartum sterilization”, section on ‘Interval laparotomy’.)
•A vaginal approach with colpotomy or culdoscopy is rarely used in current practice .
•In some settings, hysterectomy has been used for the sterilization. If there are other indications for hysterectomy such as abnormal bleeding, pelvic pain, or pelvic organ prolapse that have been appropriately evaluated, some women might find sterilization to be a secondary benefit of hysterectomy. However, we do not believe that sterilization alone is a sufficient indication for hysterectomy.
Side effects after surgery vary and may depend on the type of anesthesia used and the way the surgery is performed. You likely will have some pain in your abdomen and feel tired. The following side effects also can occur but are not as common:
If you have abdominal pain that does not go away after a few days, if pain is severe, or if you have a fever, contact your health care provider right away.
Per, Acog.org, Tubal ligation is a safe and effective form of permanent birth control. But it doesn’t work for everyone. Fewer than 1 out of 100 women will get pregnant in the first year after the procedure. The younger you are at the time it’s done, the more likely it is to fail.
If you do conceive after having a tubal ligation, there’s a risk of having an ectopic pregnancy. This means the fertilized egg implants outside the uterus, usually in a fallopian tube. An ectopic pregnancy requires immediate medical treatment. The pregnancy cannot continue to birth. If you think you’re pregnant at any time after a tubal ligation, contact your health care provider immediately.
Keep in mind that although tubal ligation reversal is possible, the reversal procedure is complicated and may not work.