Birth Control: How is Tubal Ligation Done

Tubal Ligation: Two Methods

A TUBAL LIGATION is the blockage (occlusion) of the fallopian tubes by separating, cutting, cautery, clips or silastic rings. Sterilization is considered to be an irreversible method of contraception. There is no guarantee that previous fertility can ever be restored. Successful rejoining of the fallopian tubes is very delicate, specialized surgery and difficult to accomplish.

There are two main methods of Tubal Ligation used today. The procedures can only be done by an obstetrician/ gynecologist.

A laparoscopic tubal ligation can be done anytime when a woman is not pregnant. There are three ways to block the tube: Cautery (Burning); Applying Clips (Hulka Clips); Applying Silastic Rings.
A LAPAROSCOPE is a wand shaped instrument used to see into the body. A small incision is made in the belly button (umbilicus) and gas is then infused into the abdomen. Once the abdomen is full of gas, the laparoscope is inserted. A second, puncture incision is made just above the pubic bone, while the surgeon is looking through the laparoscope (or watching on a television monitor if it is attached to a camera). A forceps-like instrument is then inserted into the abdomen through this incision. The forceps are used to grasp and elevate the tube.

This is where the difference in the laparoscopic tubal comes in.

CAUTERY: The ends of the forceps are two haves of an electrode and they squeeze the tube while an electric current is passed between them, burning the tube. This causes the most damage to the tube and is the least reversible of the three methods. The burn extends well beyond the area burned initially.
CLIPS: The clip is held between the two sides of the forcep and the tube is squeezed between the halves, thus applying the clip.
SILASTIC RINGS: The tube is grasped and pulled into the casing holding the forceps. This casing also holds a small ring a silastic material, much smaller than the tube. The tube is pulled through the ring and then dropped with the ring now in place and blocking the tube.
This is done in an out patient surgery unit and you can go home in a few hours for rest.

Postpartum Tubal Ligations are done within two days of delivery because the top of the uterus is at the level of the belly button at that time. The Mom is put to sleep (If she has had an epidural for labor, the catheter may be left. She will then have epidural anesthesia). The belly button (umbilicus) is grasped and pulled up. A small incision is made in it. The tubes are pulled through this small incision one at a time using a grasping instrument that will not tear the tube. The tube is then tied securely with suture material. The tube is then cut, and usually the cut ends are cauterized. The tube is then replaced, gently, back into the abdomen. The same procedure is done for the second tube.
After both tubes are cut, the belly button is sewn closed. Mom and baby can go home the next day.

For c-section the tubes are tied and cut at the time of delivery.

Clearing Some Misconceptions About Tubal Ligation:
Tubal Ligation does not affect the production and secretion of the female hormones, estrogen and progesterone. Therefore, there will be no masculinization developing such as voice deepening or hair growth; cessation of your period; early menopause; or decrease in libido (sex drive). Just because you had a tubal ligation does not mean you will have to have a hysterectomy some day. The days of unnecessary hysterectomy are dwindling. If a doctor advises one, always get a second opinion,

REMEMBER: This is considered a PERMANENT method of birth control. While reversal is possible in some instances, it is not a guarantee.

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