Tubal Ligation—Laparoscopic Surgery Overview

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 © 2009 Nucleus Medical Media, Inc.

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.
• 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.

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.