Tubal Ligation Overview
Tubal ligation is surgery to block a
woman's Fallopian tubes. Tubal ligation is a permanent form of
birth control. After this procedure, eggs cannot move from the ovary through the tubes (a woman has two
Fallopian tubes), and eventually to the uterus. Also, sperm cannot reach the egg in the
Fallopian tube after it is released by the ovary. Thus, pregnancy is prevented.
This procedure is also called tubal ligation or
having one's "tubes tied." More formally, it is known as bilateral tubal ligation (BTL).
Currently, about 700,000 of these procedures are performed each year in the United States. Half are performed right after a woman gives birth. The rest are elective procedures performed as a one-day operation in an outpatient clinic. Eleven million US women aged 15
to 44 years rely on sterilization as a means of birth control to prevent pregnancy. More than 190 million couples worldwide use surgical sterilization as a safe and reliable method of permanent birth control.
Prior to the 1960s, female sterilization in the United States was generally performed only for medical problems or when a woman was considered "too old" to have children or at risk
to her health. The changing cultural climate in the 1960s resulted in safe, minimally invasive female sterilization procedures.
Tubal Ligation Procedure
While the patient is under anesthesia, one or two small incisions (cuts) are made in the abdomen (usually near the navel), and a device similar to a small telescope on a flexible tube (called a laparoscope) is inserted.
Using instruments that are inserted through the laparoscope, the tubes (Fallopian tubes) are coagulated (electrocoagulation), cauterized (burned), or a small clip is placed on the tube. The skin incision is then closed with a
few stitches. Most patients feel well enough to go home after the procedure in
the outpatient surgery center after a few hours.
The health care
professional may prescribe pain medications to manage pain.
Most women return to normal activities, including work, in a few days, although
some women may be advised not to exercise for several days.
Most women resume sexual intercourse when they feel ready.
Tubal ligation can also be performed immediately after childbirth through a small incision near the navel or during a Cesarean delivery.
Currently, laparoscopy (bipolar laparoscopy, Falope ring, Filshie clip) is the most popular method of female sterilization in nonpregnant women. Periumbilical minilaparotomy (Pomeroy, Parkland) is the most common procedure right after childbirth.
Medically Reviewed by a Doctor on 6/11/2014
Avi J Sklar, MD, FACOG, FACS, FRCSC
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