A colpotomy, also known as a vaginotomy, is a procedure by which an incision is made in the vagina. A colpotomy is a type of incision that is made in the back wall of the vagina. During a tubal ligation, your doctor can use a colpotomy (also known as a vaginotomy) as one of the ways to reach your fallopian tubes. A tubal ligation that uses a colpotomy incision is considered to be minimally invasive surgery. The patient is placed in a supine position on the operating table with her legs in stirrups and the incision site is prepared. An antiseptic solution, such as chlorhexidine, is applied to the skin using highly disinfected forceps and gauze swabs. The patient is covered with surgical drapes with the window positioned directly over the incision site. Throughout the procedure, the vital signs of the patient are monitored (blood pressure, pulse, respiratory rate) as well as her level of consciousness and blood loss. Pain management depends on the surgery that requires the colpotomy, and may involve local, regional, or general anesthesia. The incision is only made as large as necessary for the requirements of the overall surgery.
For example, when a decision has been made to remove a myoma by colpotomy, the procedure may proceed as follows:
A colpotomy is performed either to visualize pelvic structures or to perform surgery on the fallopian tubes or ovaries.
The procedure is explained to the patient within the broader context of the surgery that includes the colpotomy. Preoperative preparation includes whatever is required for the overall surgical procedure that will be performed.
Aftercare for colpotomy is associated with the overall surgery that required the colpotomy.
For example, if a colpotomy is performed for tubal ligation (female sterilization), the procedure takes only 15–30 minutes and women usually go home the same day. It may take a few days at home to recover. Sexual intercourse is usually postponed until the colpotomy incision is completely healed, and as advised by the doctor. The healing process usually requires several weeks and there are no visible scars. In the case of a colpotomy performed for myoma removal, aftercare is more elaboate with the patient's vital signs monitored in the recovery room until she regains consciousness.