What is Tubal Ligation?
- Tubal ligation is surgery to block a woman's Fallopian tubes. A tubal ligation is a permanent form of birth control. After this procedure has been performed, an egg 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 ovulation (release of an egg from 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 a bilateral tubal ligation (BTL).
- Some tubal ligations are performed immediately following childbirth. The remainder are elective procedures performed as a same-day operation in an outpatient surgical facility or the hospital. Many US women aged 15 to 44 years rely on sterilization as a means of contraception (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 virtually on demand.
Tubal Ligation Procedure
While the patient is under anesthesia, one or two small incisions (cuts) are made in the abdomen (one 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 or the second incision, the tubes (Fallopian tubes) are coagulated (electrocoagulation), cauterized (burned), or a small clip is placed on each 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 analgesic medications to manage post operative pain.
Most women return to normal activities, including work, in a few days, although some women may be advised not to exercise for a short time. Sexual intercourse may resume when the patient is comfortable.
Tubal ligation can also be performed immediately after childbirth through a small incision near the navel or at the time of a Cesarean section.
Currently, laparoscopic tubal ligation (bipolar laparoscopy, Falope ring, Filshie clip) is the most popular method of female sterilization in nonpregnant women. Periumbilical minilaparotomy in which a segment of each tube is removed through a small incision in the umbilicus, (Pomeroy, Parkland) is the most commonly used procedure immediately following childbirth.
Last Reviewed 12/18/2015
Avi J Sklar, MD, FACOG, FACS, FRCSC
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