Sterilization by laparoscopy is a surgical procedure that provides permanent birth control for women. Female sterilization involves obstruction or removal of the fallopian tubes.
The fallopian tubes are on either side of the uterus and extend toward the ovaries. They receive eggs from the ovaries and transport them to the uterus. Once the fallopian tubes are closed or removed, the man's sperm can no longer reach the egg.
Laparoscopy enables the physician to complete tubal ligation or tubal removal by making a small incision near the navel. This smaller incision reduces recovery time after surgery and the risk of complications. In most cases, the woman can leave the surgery facility within four hours after laparoscopy.
A woman should carefully weigh her decision to undergo sterilization by laparoscopy. Though this procedure has been successfully reversed in some women, the procedure is intended to produce permanent loss of fertility.
Women who are unsure if they still want children should choose a reversible form of contraception, such as birth control pills, an intrauterine device (IUD), or a barrier method (such as a diaphragm). Discuss these alternatives with your physician.
Your partner may also consider having a vasectomy, a method of male sterilization that involves severing and tying the vas deferens, a tube that transports sperm.
For women who no longer want children, sterilization by laparoscopy provides a safe and convenient form of contraception. Once completed, no further steps are needed to prevent pregnancy.
However, laparoscopy may not be suitable for some women. In these cases, tubal ligation or removal may be performed by laparotomy, a more extensive surgery that requires a larger abdominal incision and a day or two of recovery in the hospital.
Tubal ligation or removal does not change a woman's menstrual cycle or cause menopause.
Before your laparoscopy:
. Do not eat, drink (including water) or smoke after midnight the evening before your surgery.
. Wear low-heeled shoes the day of surgery. You may be drowsy from the anesthesia and unsteady on your feet.
. Do not wear jewelry. (Wedding rings may be worn.)
. Wear loose-fitting clothing. You will have some abdominal tenderness and cramping after surgery.
. Bring a sanitary pad. You may have some vaginal bleeding after surgery.
. Remove nail polish from at least one finger prior to surgery.
An intravenous line (I.V.) will be inserted into a vein in your hand or arm. You will be given a general anesthetic in the I.V. to relax your muscles and prevent pain during surgery. After your anesthesia is started, you will be positioned for surgery and antiseptic will be applied to your skin to prevent infection. A speculum will be placed in the vagina. A device will be gently inserted into the uterus so that the uterus can be positioned as needed during the procedure.
A small incision is then made near the navel. A laparoscope, a thin viewing tube about the width of a pencil, is passed through this incision and the abdomen is inflated to make the organs easier to view.
A special device for grasping the fallopian tubes is inserted through a second, small incision made at the pubic hairline. The fallopian tubes are sealed in one of two ways:
. With an electric current that makes the tube clot (electrocoagulation)
. With a band or clip that is placed over the tubes. In some cases, a device will be used to separate the tubes from the uterus and the ovaries, and the tubes will be removed from the body.
After the fallopian tubes have been sealed or removed, the laparoscope and grasping device are removed and a small bandage is applied over the incisions.
Recovering at home:
. Don't drink alcohol or drive for at least 24 hours after surgery.
. You can shower any time after surgery. You can take a tub bath or swim beginning two weeks after surgery.
. You may remove the bandage the morning after the surgery. Steri-strips, which resemble tape, can be removed two to three days after surgery.
. Patients can return to work three days after surgery. (If you need a physician's letter excusing you from work, please request one before the day of surgery.)
. Your abdomen may be swollen for several days after the surgery. Tylenol® may be taken to relieve pain.
. You may have a sore throat for a few days. Try using a throat lozenge.
. You may have mild nausea. Try eating a light evening meal the day of surgery. Tea, soup, toast, gelatin or crackers may help relieve nausea.
. Gas in the abdomen may cause discomfort in the neck, shoulders, and chest for 24 to 72 hours after surgery. Try taking a warm shower, using a heating pad or walking.
Vaginal bleeding up to one month after surgery is normal. Many women do not have their next normal menstrual cycle for four to six weeks after surgery. When your normal cycle returns, you may notice heavier bleeding and more discomfort than usual for the first two to three cycles.
You can resume sexual activity one week after surgery.
After surgery, patients stay in a recovery room and are observed for any possible complications. Patients are discharged after they receive instructions for home recovery. Patients are asked to see their physicians for a follow-up appointment within two to eight weeks.
Contact your physician immediately if you experience any of the following:
. Persistent nausea and vomiting for more than 24 hours.
. Temperature over 100 degrees Fahrenheit for more than 24 hours.
. Redness, swelling, drainage or bleeding around the incision.
. After the first day of surgery:
. Heavy bleeding with clots
. Soaking a sanitary pad within two hours