Getting Your Tubes Tied

Getting Your Tubes Tied

By Margaret Gaia

“Getting your tubes tied” is a phrase or term which is used commonly to describe one process of contraception in the female anatomy.  The medical term for this is “tubal ligation”.  Transabdominal sterilization is a type of tubal ligation in which the female’s fallopian tubes are closed off and sealed.  Once this occurs, the male sperm cannot make it to the egg to begin the fertilization process in the pregnancy.   There are typically five main instances in which this can occur:

- Laparoscopy
- Mini-Laparoscopy
- Laparotomy
- Culdoscopy & Culpotomy
- Hysterectomy

Laparoscopy is one of the most common types of sterilization where the surgeon will close off the fallopian tubes with clamps or rings, or will even seal them shut with an electric current.  The process of laparoscopy is quite simple, and common.  First, general anesthesia is given to the patient.  A small incision is made in or just below the belly button.  The instruments are inserted and used to complete the process, which takes 30 minutes or less, and then the patient is typically released within the same day.  Instruments used in this process are laparoscope with is a small, lighted telescope, a device to hold the tubes while the surgeon closes them shut, and the clamps used to complete the process.

A mini-laparoscopy is the second most common procedure.   It is performed by making a small incision just above the pubic area, and is typically performed right after childbirth.  Gas and a laparoscope is not used in this procedure, however the surgeon will raised the fallopian tubes above the incision to seal them instead.  Since the patient is already in the hospital for childbirth, this procedure is typically performed just two days or 48 hours after the birthing process. 

Laparotomy is defined as an incision through the flank, or any area of the abdominal wall. This procedure is a bit more serious, as the surgeon will make the incision in excess of 2 to 5 inches in the abdominal region.  The fallopian tubes will be pulled out, closed off, and put back in place.  A patient can stay 2 to 4 days in the hospital when this procedure is performed.  Incisions that are made for this procedure to be possible are typically stitched, as they are larger than other alternatives.    Laparotomy is usually going to be performed to a patient that is electing to have this form of contraception and has a scheduled C-Section for the purposes of childbirth. 

Culdoscopy and culpotomy are two types of vaginal sterilization.  With culdoscopy, the surgeon will make an incision into the vaginal fornix, where a culdoscope will be inserted. This instrument will be inserted into the peritoneal cavity to seal the fallopian tubes shut.   With culpotomy, the same process is performed, however the tubes are pulled out to perform the procedure rather than using an instrument internally.   Both procedures take about 30 minutes to perform and the patient is released within the same day given that recovery is cooperative.

A hysterectomy is the procedure of removing the uterus all together.  It is a major surgery and is not typically used solely for sterilization.   This procedure cannot be reversed, will end all possibilities of pregnancy, and will end menstruation.  Unlike the other procedures, the fallopian tubes will not be affected with this procedure.  Women will require several days in the hospital and several weeks recovery at home.