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Laparoscopic Sterilization

Laparoscopic Sterilization or Tubal ligation also known as "tying the tubes" is surgery to close a woman's fallopian tubes so that she can no longer get pregnant.

Normally, a woman's fallopian tubes move eggs from the ovary to the uterus about once a month. If a man's sperm meets up with an egg, pregnancy can result. If the tubes are closed, or "tied," sperm cannot fertilize an egg and pregnancy will not occur.

Tubal ligation, or getting one's "tubes tied," refers to female sterilization, the surgery that ends a woman's ability to conceive. The operation is performed on the patient's Fallopian tubes. These tubes, which are about 10 cm long and 0.5 cm in diameter, are found on the upper outer sides of the uterus and open into the uterus through small channels. It is within the Fallopian tube that fertilization, the joining of the egg and the sperm, takes place. During tubal ligation, the tubes are cut or blocked in order to close off the sperm's access to the egg.

Normally, tubal ligation takes about 20–30 minutes and is performed under general anesthesia, spinal anesthesia, or local anesthesia with sedation. The surgery can be performed on either hospitalized patients within 24 hours after childbirth or on outpatients. The woman can usually leave the hospital the same day.

The most common surgical approaches to tubal ligation include laparoscopy and mini-laparotomy. In a laparoscopic tubal ligation, a long, thin telescope-like surgical instrument called a laparoscope is inserted into the pelvis through a small cut about 1 cm long near the navel. Carbon dioxide gas is pumped in to help move the abdominal wall to give the surgeon easier access to the tubes. Often the surgical instruments are inserted through a second incision near the pubic hair line. An instrument may be placed through the vagina to hold the uterus in place.

BRIEF ABOUT THE PROCEDURE

In a mini-laparotomy, a 3–4 cm incision is made just above the pubic bone or under the navel. A larger incision, or laparotomy, is rarely used today. Tubal ligation can also be Laparoscopic Sterilizationperformed at the time of a cesarean section.

Tubal ligation is done in the hospital or outpatient clinic while you are under anesthesia. The surgeon will make one or two small cuts in your belly area, usually around the belly button.

The doctor will insert a narrow tube with a camera on the end (laparoscope) into the pelvic area. Instruments to tie the tubes are sent through the laparoscope. The tubes are either cauterized or shut off with a small clip. One will be able to go home after a few hours.

Tubal ligation can also be done right after vaginal childbirth through a small cut near the belly button, or during a cesarean section.

Tubal ligation may be recommended for adult women who are certain that they do not want to get pregnant in the future.

While sterilization is very popular, some women who choose to have the procedure regret their decision later. The younger the woman, the more likely that she will regret having her tubes tied. Tubal ligation is considered a permanent form of birth control. It is NOT recommended as a temporary or reversible procedure. However, the operation can sometimes be reversed if a woman later chooses to become pregnant. This requires a major surgical procedure. About 50 - 80% of women who have tubal ligation reversed become pregnant.

SOME ASSOCIATED RISKS
  • Incomplete closing of the tubes, which could result in a future pregnancy (about 1 out of 200 women who have had tubal ligation get pregnant later)
  • Increased risk of a tubal (ectopic) pregnancy if pregnancy occurs after a tubal ligation
  • Injury to nearby organs or structures caused by surgical instruments

Risks due to anesthesia may include problems related to breathing and certain reactions to medications.

Most women recover with no problems. There are no tests needed to make sure the procedure will prevent pregnancy in the future.

TIPS ON RECOVERY

Risks for tubal ligation include

  • Avoid heavy exercise for several days after the procedure.
  • Pain medicine may help relieve discomfort.
  • You can have sexual intercourse as soon as you feel ready, usually within a week.
  • You may be able to return to work within a few days.
RELATED ARTICLES
HOSPITALS FOR LAPAROSCOPIC STERILIZATION
DESTINATIONS FOR LAPAROSCOPIC STERILIZATION

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