Tubal ligation

Alternative Names: Sterilization surgery - female; Tubal sterilization; Tube tying; Tying the tubes; Hysteroscopic tubal occlusion procedure

Tubal ligation (or "tying the tubes") is surgery to close a woman's fallopian tubes. These tubes connect the ovaries to the uterus. A woman who has this surgery can no longer get pregnant (sterile).

Description of Procedure

Tubal ligation is done in a hospital or outpatient clinic.

• You may receive general anesthesia. You will be asleep and unable to feel pain.
• Or, you may have local anesthesia (awake and unable to feel pain) or spinal anesthesia (awake but unable to feel pain). You will likely also receive medicine to make you sleepy.

The procedure takes about 30 minutes.

• Your surgeon will make one or two small surgical cuts in your belly, usually around the belly button. Gas may be pumped into your belly to expand it. This helps your surgeon see your uterus and fallopian tubes.
• Your surgeon will insert a a narrow tube with a tiny camera on the end (laparoscope) into your belly. Instruments to block off your tubes will be inserted through the laparoscope or through a separate, very small cut.
• The tubes are either burned shut (cauterized) or clamped off with a small clip or ring (band).

Tubal ligation can also be done right after you have a baby through a small cut in the navel or during a cesarean section.

Another sterilization method involves going through the cervix and placing coils or plugs in the tubes where they connect with the uterus (hysteroscopic tubal occlusion procedure). This technique does not involve cuts in the abdomen.

Risks of Tubal ligation

Risks for any surgery are:

• Bleeding
• Damage to other organs (bowel or urinary systems) needing more surgery for repair
• Infection

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems or pneumonia
• Heart problems

Risks for tubal ligation are:

• Incomplete closing of the tubes, which could make pregnancy still possible. 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 tissues from surgical instruments

Tubal ligation	Tubal ligation - series

Review Date: 2/28/2011
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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