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    TOP

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 consider all the birth control options for you and your partner.

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Potential problems include:

Some factors that may increase the risk of problems include:

What to Expect    TOP

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 one week before the procedure, like:
    • Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen
    • Blood thinners
    • Anti-platelet medications
  • 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    TOP

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 one 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    TOP

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?    TOP

20-30 minutes

How Much Will It Hurt?    TOP

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. Ask your doctor about medication to help with the pain after the procedure.

Post-procedure Care    TOP

At the Care Center

You can usually go home the same day. You may need to stay longer if you have complications.

At Home

To help ensure a smooth recovery:

  • Follow your doctor's instructions on cleaning the incision site.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.

Call Your Doctor    TOP

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
  • Cough, shortness of breath, or chest pain
  • Lightheadedness or fainting
  • Pain and or swelling in one or both legs
  • Heavy vaginal bleeding after the first day
  • Missed menstrual period

If you have an emergency, call for emergency medical help right away.

RESOURCES:

Women's Health—US Department of Health and Human Services
http://www.womenshealth.gov

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 College of Obstetricians and Gynecologists website. Available at:
...(Click grey area to select URL)
Updated August 2011. Accessed March 18, 2014.
Sterilization for women (tubal sterilization). Planned Parenthood website. Available at:
...(Click grey area to select URL)
Accessed March 18, 2014.
Tubal sterilization. American Academy of Family Physicians Family Doctor website. Available at:
...(Click grey area to select URL)
Updated July 2010. Accessed March 18, 2014.
Tubal sterilization. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated September 26, 2013. Accessed March 18, 2014.
6/3/2011 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
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 March 2013 by Andrea Chisholm, MD
Last Updated: 3/18/2014