Why Choose Tubectomy? Key Benefits and Considerations of Tubal Ligation

Tubal means Fallopian tube, and ligation refers to the tying of tubes. Usually, females have two Fallopian tubes, also known as oviduct or uterine tubes, located on either side of the uterus. These Fallopian tubes are around 10 to 12 cm in length. Tubal ligation surgery includes closing the Fallopian tubes by cutting and tying the ends of the fallopian tubes, placing implants or applying clips, rings or clamps.

Who can undergo a tubectomy?

• Women who have children and do not wish to have any more children
• Women who do not want to have children

Types of procedures or methods of tubectomy

Laparoscopy

• It is a simple and most commonly used method for tubectomy surgery, where small cuts are made to tie the fallopian tube with either clamps, rings or clips. Alternatively, an electric current can also be used to close the fallopian tubes. This procedure takes about half an hour and can be recovered easily. 

Bilateral salpingectomy

• In this method, both the fallopian tubes are removed. Here, the risk of ovarian cancer is less when compared to Laparoscopy. In recent years, this has been the method of choice for tubectomy due to the risk of ovarian cancer and contraception failure.

Tubal occlusion

• In this method, clips or silicone bands are placed in the fallopian tube.

Open approaches

• This procedure is performed immediately after the caesarean delivery.

Parkland technique

• In this technique, the proximal and distal ends of the fallopian tubes are tied using two dissolvable sutures.

Pomeroy method

• In this method, a loop is created by placing a rapidly absorbable plain gut suture around the proximal and distal portions of the fallopian tube.  

Hysteroscopy

• This procedure, which involves threading of the fallopian tube with a small metallic coil, is usually not advised due to the risk of an allergy, and it takes more time to confirm the outcome.

Pre-operative evaluation

Before the tubectomy surgery, the patient should undergo common medical assessments, such as lung, heart and stomach. Sometimes, pelvic examination, including ultrasound, is important to find out if any cysts are present. A cervical cancer screening test should also be conducted before the procedure. A pregnancy test can also be conducted to confirm whether you are pregnant or not before the procedure.

Advantages:

Tubectomy is the most commonly and widely used procedure to stop pregnancy worldwide. It is a safe, hormone-free and highly effective method.

Disadvantages or complications:

People who have undergone tubectomy have no complications. Complications that may arise during or after the surgery are usually minor and can be addressed. However, some serious complications are listed below:

• Intra-operative complications:
• Nausea and vomiting
• Respiratory depression
• Urinary bladder injury
• Convulsions and allergic reactions to anaesthesia
• Post-operative complications:

Infections: Sometimes, infections may occur at the site of cuts or incisions.

Ectopic pregnancy: Women under 30 who have had the bipolar coagulation procedure face a higher risk of ectopic pregnancy.

Regret: Since tubectomy is a permanent procedure, some people who want a child after tying their fallopian tubes might regret undergoing this procedure. The risk factors of regret include being uninformed about the procedure, unaware of alternative methods of contraception and making a medical emergency or decision under pressure from the partner.  

Post-operative care

Do:

• Complete rest is recommended for about seven days.
• The wound should be kept clean, and instructions should be followed as per the doctor.
• Periods pads can be used if there is a vaginal bleeding.
• Painkillers suggested by the doctor can be taken if tummy pain occurs.
• Hot water bags can be used for bloating.  

Don’t:

• Avoid lifting heavy objects or exercise for about seven days.
• Refrain from sexual activity for at least seven days after the surgery.
• Avoid driving.
• Avoid using tampons after the procedure.