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

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems like:
  • Infection
  • Bleeding
  • Anesthesia-related problems
  • Damage to other organs
  • Ectopic pregnancy
Some factors that may increase the risk of problems include:

What to Expect

Prior to Procedure

Your doctor will do a physical exam and pregnancy test.
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-thinning drugs
    • Anti-platelet drugs
  • 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. 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 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 will 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 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 tools 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. Ask your doctor about medication to help with the pain after the procedure.

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
To help ensure a smooth recovery:
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.
  • Be sure to follow your doctor's instructions.

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
  • 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 medical help right away.

RESOURCES

Planned Parenthood http://www.plannedparenthood.org

US Department of Health and Human Services Women's Health 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: http://www.acog.org/~/media/For%20Patients/faq011.pdf?dmc=1&ts=20130422T1556422204. Accessed April 22, 2013.

Sterilization for women (tubal sterilization). Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/birth-control/sterilization-women-4248.htm. Accessed April 22, 2013.

Tubal sterilization. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/prevention-wellness/sex-birth-control/birth-control/tubal-sterilization.html. Updated July 2010. Accessed April 22, 2013.

Tubal sterilization. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 16, 2013. Accessed April 22, 2013.

6/3/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: 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.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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