Tubal Ligation

The fallopian tubes are transected or occluded by electrocautery. Postpartum laparotomy is done 1-3 days after childbirth with a small subumbilical incision.

Under general anesthesia, the tubes are isolated and are then crushed, ligated, electrocoagulated, banded, or plugged. Interval minilaparotomy uses a suprapubic incision with similar techniques. Sterilization can be done at any time.  One or two incisions are made in the subumbilical area, the abdomen is distended with carbon dioxide gas, the laparoscope is introduced through a trocar, and the fallopian tube is visualized. The procedure is done to the middle part of the tube.

Complications
  • coagulation burns on the bowels
  • bowel perforation
  • infection
  • hemorrhage
  • adverse anesthesia effects
Reversal

Reversal depends on many factors, including the portion of the tube excised, the presence or absence of the fimbriae, and length of the tube remaining. Successful pregnancy rates are 40-75%