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Tubal Ligation—Laparoscopic Surgery

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

Definition

Fallopian tubes are tubes that lead from the ovaries to the uterus. A tubal ligation is a sterilization procedure to close the tubes.
Options to Close Tubes
Tubal ligation
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Reasons for Procedure

Tubal ligation is done to prevent pregnancy. If you have this surgery, you will still ovulate and menstruate. The cut or blocked tubes keep the egg and sperm separated. 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 and your partner consider all the birth control options.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Potential problems include:
  • Infection
  • Bleeding
  • Adverse reactions to anesthesia
  • Damage to other organs
  • Ectopic pregnancy
Some factors that may increase the risk of problems include:

What to Expect

Prior to Procedure

A physical exam and pregnancy test will be done.
Leading up to your procedure:
  • You may need to stop taking some medications up to 1 week before the procedure.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.

Anesthesia

You may receive 1 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

A small cut will be made in the area of the navel. A harmless gas will then be inserted through this cut and into your abdomen. The gas will inflate the abdominal cavity. This will make it easier to view the internal organs. A long, thin instrument called a laparoscope will be inserted. It will contain a small camera and lighting system, which will let the doctor see inside the abdomen. A second cut may be made just above the pubic hair to insert an instrument for grasping the fallopian tubes. The tubes will be closed in 1 of the following ways:
  • Ligation—tying and cutting of the tube
  • Sealing by creating scar tissue
  • Removing a small piece of the tube
  • Applying plastic bands or clips
The instruments will then be removed and the openings will be closed with stitches.
In some cases, the doctor may switch to an open surgery. This involves making a larger incision.

Immediately After Procedure

You will be brought into the recovery room. You will rest there until the anesthesia wears off. You may receive pain medication.

How Long Will It Take?

20-30 minutes

How Much Will It Hurt?

Anesthesia will keep you comfortable and pain free during the procedure. You may feel bloated and have pain in your shoulder or chest because of the air inserted into your abdomen. Pain and discomfort after the procedure can be managed with medications.

Post-procedure Care

At the Care Center
You can usually go home the same day. You may need to stay longer if you have complications.
At Home
Follow your doctor's instructions to help ensure a smooth recovery.
Follow your doctor's instructions to help ensure a smooth recovery.

Call Your Doctor

Call your doctor if any of the following occur:
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision sites
  • Severe and continuous abdominal pain
  • Nausea and vomiting lasting more than a day
  • Pain and or swelling in one or both legs
  • Heavy vaginal bleeding after the first day
  • Missed menstrual period
If you think you have an emergency, call for emergency medical help right away.

RESOURCES

Office on Women's Health—US Department of Health and Human Services
http://www.womenshealth.gov
Planned Parenthood
http://www.plannedparenthood.org

CANADIAN RESOURCES

Canadian Women's Health Network
http://www.cwhn.ca
The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

References

Peterson HB. Sterilization. Obstet Gynecol. 2008;111:189-203.
Sterilization for women and men. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq011.pdf?dmc=1&ts=20130422T1556422204. Updated August 2011. Accessed February 24, 2016.
Sterilization for women (tubal sterilization). Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/birth-control/sterilization-women-4248.htm. Accessed February 24, 2016.
Tubal sterilization. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115331/Tubal-sterilization. Updated January 8, 2016. Accessed October 10, 2016.
Tubal sterilization. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/prevention-wellness/sex-birth-control/birth-control/tubal-sterilization.html. Updated July 2010. Accessed February 24, 2016.
6/3/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115331/Tubal-sterilization: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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