Tubal ligation(Tubectomy)

Tubal Ligation is a surgical procedure of the fallopian tubes that prevents pregnancy permanently. It is also known as tubectomy and involves the cutting or blocking of the fallopian tubes. This stops the egg from traveling from the ovary to the uterus so fertilization and implantation cannot occur. Tubectomy can be performed at any time, including after childbirth or along with another abdominal procedure, such as a C-section. Most tubal ligation procedures are irreversible. If reversal is attempted, it necessitates major surgery and is not always successful.

tubal ligation


Types of tubal ligation

There are different types of tubal ligation:

Bipolar coagulation

In this procedure, an electric current is applied to cauterize different sections of the fallopian tubes. These sections are typically 2-3cm long.

Monopolar coagulation

The fallopian tubes are cauterized together using an electric current. The current is then increased in order to damage the remaining of the tubes.

Tubal ring

A silicone band is placed over the doubled portion of the fallopian tubes.

Tubal clip

A permanent clip, similar to a tubal ring, is applied and fastened to the doubled portion of the fallopian tubes.

Fimbriectomy

The fallopian tube closest to the ovary is cut and removed.

When Can Tubal Ligation Be Performed?

Postpartum

Immediately after delivering a baby (cesarean section or vaginal delivery).

Postabortion

Immediately after abortion (whether spontaneous or induced).

Interval

A scheduled procedure specifically for a tubal ligation unrelated to pregnancy.


Procedure

Tubal ligation may be done while you are recovering from vaginal childbirth or during C-section delivery. It can also be carried out as an outpatient procedure (interval tubal ligation) that is separate from childbirth.

Before the procedure

  • You may be advised to take a pregnancy test to ensure you are not pregnant.
  • You may be asked to stop taking aspirin, ibuprofen, warfarin, and any other drugs that make it hard for your blood to clot.
  • If you smoke, try to stop. Ask your doctor for help quitting.
  • You may be asked to fast after midnight the night before your surgery or 8 hours before the time of your surgery.
  • Take the drugs your provider told you to take with a small sip of water.

During the procedure

In hysteroscopy approach or trans-uterine tubal occlusion: You will be given anesthesia. The cervix is dilated and a hysteroscope is placed in the uterine cavity. The fallopian tube opening into the uterus is identified, and a "plug" is inserted into the tube as it passes through the uterine wall.


In minilaparotomy procedure,

In this procedure, you will be given either general or regional anesthesia (most commonly an epidural) and then the surgery would then be performed as the following:

  • The surgeon will make a small, visible incision just beneath the belly button.
  • The fallopian tubes are then drawn up toward the incision.
  • A segment of the tube is cut to prevent it from being functional.
  • The tubes will then be put back into place and the incision is closed with stitches.

In laparoscopic procedure,

  • One or more small incisions near your belly button will be made by the surgeon. The surgeon may also make a small incision in your lower abdomen.
  • Gas may be pumped into your stomach to inflate it. This gives the surgeon a better view and more room to work.
  • A narrow tube with a camera and a light on the end will be inserted into your abdomen by the surgeon. This tube is known as a laparoscope.
  • The surgeon will use long, thin instruments inserted through the laparoscope or another small incision to locate and grasp the fallopian tubes.
  • Electric current can be used to cut, tie, clamp, band, or seal the tubes.
  • Following surgery, the surgeon will close the incisions in the skin, most likely with 1 to 2 stitches. He or she will apply small dressings to cover the area.

After the procedure

After a tubal ligation, you will most likely go home the same day. Your surgeon will give you instructions about what to expect and when to take follow-up appointments after the surgery.

  • The movement of the uterus during the surgery may cause some minor vaginal bleeding.
  • If you had a laparoscopy, the air used to lift or separate your skin and muscles away from your uterus so the surgeon could see them better may have caused your stomach to swell (distended). This should pass in a day or two, but it could last longer. You may also experience back or shoulder pain as a result of the air in your stomach. As your body absorbs the air, it may fade.
  • You can shower 24 hours later after the tubectomy. But avoid rubbing or pulling the incision area for at least a week.
  • Be sure to take rest for a few days before you start to resume your normal activities. You should be able to resume all activities within a week.

Benefits and Risks

Benefits

  • Tubectomy may permanently prevents pregnancy, so you no longer need to use any type of birth control methods.
  • Tubectomy surgery may reduce the risk of ovarian cancer, particularly if the fallopian tubes are removed.
  • Tubectomy does not cause hormonal imbalances or contraindications which are commonly seen with the use of oral contraceptives.
  • Removing or blocking the fallopian tubes is shown to decrease the chances of contracting pelvic inflammatory disease.
  • It can be done at the same time as another surgery such as a C-section.
  • Tubal ligation won't affect your menstrual cycle.
  • It won't affect your desire for sex.

Risks

Possible risks and complications from the tubal sterilization operation include:

  • An allergic reaction to the anesthetic
  • Damage to nearby organs, such as the bowel or ureters
  • Infection, inflammation and ongoing pain
  • Hemorrhage (heavy bleeding)
  • Infection of the wound or one of the fallopian tubes.

Longer-term possible risks and complications of tubal sterilization include:

  • Pregnancy (the method is 99% effective, but there is a very small chance of the tubes getting unblocked, which would lead to pregnancy)
  • Ectopic pregnancy, in which pregnancy develops outside the uterus (usually in the fallopian tubes) rather than in the uterus (womb).
  • Post tubal ligation syndrome: The symptoms of post tubal ligation syndrome are menstrual problems, pain during intercourse, weight gain, absence of menstruation, abnormal uterine bleeding, pelvic pain, increased headaches and lower back pain.

Tubectomy Care at Medicover

At Medicover, we provide the best treatment and care for tubectomy. Guided by our top gynecologists and obstetricians, the entire surgical procedure is focussed towards rapid recovery. Our highly skilled medical team utilizes their in-depth knowledge, quality care and professionalism to give you the best experience. Ensuring your comfort, our doctors will help you choose the best approach for tubectomy as per your need. We provide a wide variety of gynecological procedures using the most advanced technologies and world-class equipment to bringing out the best possible outcomes.



Make an appointment just in few minutes - Call Us Now


Frequently Asked Questions

1. Does tubal ligation affect periods and sexual life?

No. You will still have periods and can have sex after the procedure. In fact, because they do not have to worry about an unwanted pregnancy, women may feel more at ease. Tubectomy is a permanent method of contraception.

2. What changes occur after tubectomy?

In the days following the tubal ligation there can be localized abdominal pain around the incision site for which a doctor may prescribe painkillers, and some women may experience dizziness, fatigue, cramping, bloating, gassiness or shoulder pain.

3. Which type of tubectomy is best?

The most popular is the laparoscopy method in which the patient may have a couple of small scars and is discharged home the same day. If laparoscopy is not available an open surgical operation may be required.

4. Where do eggs go after tubectomy?

Each ovary still releases an egg after tubectomy. But the passage of eggs through the fallopian tube is now arrested. Sperm also cannot reach the egg passing through the tube. Pregnancy cannot occur when the egg and sperm cannot meet; your body absorbs the egg.

5. Can a tubectomy be reversed?

Yes. It is possible to reverse a tubectomy but it is a major surgery that doesn’t always work and expensive.

Citations:

https://uihc.org/health-topics/tubal-ligation-permanent-birth-control-surgery
https://www.ncbi.nlm.nih.gov/books/NBK549873/
https://www.healthlinkbc.ca/health-topics/tubal-ligation-surgery