Tubal Ligation—Laparoscopic Surgery
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Tubal Ligation—Laparoscopic Surgery

(Surgical Sterilization; TL; Tubal Sterilization; Sterilization, Tubal; Sterilization, Surgical)

En Español (Spanish Version)

Definition

This is a surgery to close a woman's fallopian tubes. A fallopian tube runs from the ovary (where the eggs develop) to the uterus (womb). Closing this tube makes it so that a woman cannot get pregnant.

Options to Close Tubes

Tubal ligation

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Reasons for Procedure

Tubal ligation is done if you do not want to become pregnant. If you have this surgery, you will still ovulate and menstruate. The cut or blocked tubes keep the egg and sperm from meeting. When the egg and sperm cannot meet, fertilization does not happen and pregnancy cannot occur.

This surgery is not recommended as a temporary or reversible procedure. Make sure you consider all the birth control options for you and your partner.

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have tubal ligation, your doctor will review a list of possible complications, which may include:

  • Infection
  • Bleeding
  • Anesthesia-related problems
  • Damage to other organs
  • Pregnancy—If pregnancy occurs, there is an increased risk that the egg will implant outside of the womb.

Some factors that may increase the risk of complications include:

Be sure to discuss these risks with your doctor before the procedure.

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • Discuss your reason for this procedure
  • Pregnancy test

Leading up to your procedure:

  • If you had to stop medicines before the procedure, ask your doctor when you can start again. Medicines often stopped include:
    • Anti-inflammatory drugs (eg, aspirin )
    • Blood thinners, like warfarin (Coumadin)
    • Clopidogrel (Plavix)
  • The night before, eat a light meal. Do not eat or drink anything after midnight.

Anesthesia

You may receive one of the following:

  • General anesthesia—blocks pain and keeps you asleep through the surgery
  • Spinal anesthesia—numbs the area from the chest down to the legs; given as an injection in the back

Description of the Procedure

The doctor will make a small cut in the area of the navel. Through this cut, she will inject a harmless gas into your abdomen. The gas will inflate the abdominal cavity. This will make it easier for the doctor to see the internal organs. The doctor will then insert a long, thin tool (called a laparoscope). This tool will contain a small camera and lighting system which let the doctor see inside the abdomen. The doctor may make a second cut just above the pubic hair to insert a tool for grasping the fallopian tubes. The tubes will be closed by one of the following ways:

  • Tying and cutting (ligation)
  • Sealing by creating scar tissue
  • Removing a small piece of the tube
  • Applying plastic bands or clips

The tools will then be removed and the openings will be closed with stitches.

In some cases, the doctor may switch to an open surgery. She will either make a small cut just above the pubic hair or below the navel, or a 2-5–inch cut in the abdomen to do the surgery.

Immediately After Procedure

You will be brought into the recovery room. You will rest there until the anesthesia wears off.

How Long Will It Take?

20-30 minutes

How Much Will It Hurt?

You may have some pain during recovery. Ask your doctor about pain medicine. Also, since your abdomen will be injected with gas, you may feel bloated and have pain in your shoulder or chest after the surgery. This may last up to three days. Walking, using a heating pad, or taking a warm shower can help to decrease discomfort.

Average Hospital Stay

You can usually go home the same day as the surgery. Your doctor may choose to keep you longer if complications arise.

Post-procedure Care

When you return home, do the following to help ensure a smooth recovery:

  • Remove the bandage the morning after surgery. Let the small paper strips fall off on their own.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Do not drive or drink alcohol for at least 24 hours after surgery.
  • Do not lift anything heavy or perform hard labor for at least a week.
  • If you are nauseous, try tea, toast, or crackers.
  • Avoid sexual activity for one week, or as directed by your doctor.
  • Be sure to follow your doctor's instructions.

You should be able to return to work in 1-7 days. Your menstrual cycle will resume in 4-6 weeks. Sterilization success rates are greater than 99% during the first year. Tubes may later grow together, increasing pregnancy risk.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision sites
  • Severe and continuous abdominal pain
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • Fainting or dizziness
  • Pain and or swelling in one or both legs
  • Nausea and vomiting lasting more than a day
  • Heavy vaginal bleeding after the first day
  • Missed menstrual period

In case of an emergency, CALL 911 .

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org/publications/patient_education/

Planned Parenthood
http://www.plannedparenthood.org/

Women's Health.gov
http://www.womenshealth.gov/

CANADIAN RESOURCES:

Canadian Women's Health Network
http://www.cwhn.ca/en/

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org/

References:

Engender Health website. Available at: http://www.engenderhealth.org/ . Accessed July 10, 2008.

Peterson HB. Sterilization [abstract]. Obstet Gynecol . 2008;111:189-203.

Tubal ligation. Planned Parenthood website. Available at: http://www.plannedparenthood.org/BIRTH-CONTROL/allabouttubal.htm . Accessed July 10, 2008.

Tubal sterilization. American Academy of Family Physicians. Family Doctor.org website. Available at: http://familydoctor.org/online/famdocen/home/women/contraceptive/792.html . Updated July 2010. Accessed November 15, 2010.

6/3/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.



Last reviewed September 2010 by Silpa Senchani, MD


Last updated Updated: 6/3/2011

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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