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Diagram of tubal ligation: Tubal Ligation – StatPearls – NCBI Bookshelf

Tubal Ligation – Family Planning

Tubal Ligation – Family Planning

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What is tubal ligation?

Permanent contraception is called sterilisation.

A tubal ligation (also known as ‘having your tubes tied’) is a procedure to close both fallopian tubes which means that sperm can’t get to an egg to fertilise it.

How is a tubal ligation done?

The tubes are closed using rings or clips or by cutting and tying.

It is usually done by putting a tiny telescope called a laparoscope in through a small cut near the belly button and closing the tubes through another small cut near the pubic hair.

If a laparoscope can’t be used then a longer cut is made near the pubic hair.

Tubal ligations are done in hospital under a general anaesthetic. Depending on the type of operation it may be day surgery or may require a stay of one to two days in hospital.

How effective is tubal ligation?

The failure rate for tubal ligation is one in 200.

Does Family Planning do tubal ligations?

We don’t do tubal ligations at our clinics.

Our nurses and doctors can refer you to a hospital or to a specialist who can perform the procedure.

Talk to our staff if you think tubal ligation might be an option for you.


It is not always possible to reverse tubal ligation and the reversal procedure is not available in public hospitals.

If you consider your decision carefully and do not feel pressured by anyone, you are unlikely to regret your choice.


It is recommended that you discuss sterilisation fully with your partner. This is because you are both affected by the decision.

However, it is not a legal requirement for your partner to give consent. You can choose a tubal ligation if you have no partner or if you have no children.

Family Planning has clinics located throughout New Zealand. Use the clinic finder to find your nearest clinic.

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Visits are free if you are under 22 (NZ residents only)

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Tubal Factor (Fallopian Tubes) Infertility

What are fallopian tubes?

Fallopian tubes are the delicate hollow tissue that connects each ovary to the uterus. Once an ovary releases an egg, it travels through the fallopian tube toward the uterus. If sperm are present in the uterus, they will swim up the tube toward the egg.

Fertilization normally takes place in the fallopian tubes. Tiny hair-like tissue inside the tubes, called cilia, then sweep the embryo toward the uterus. Once there, it should implant into the uterine lining and grow for nine months.

Tubal factor infertility at a glance
  • Two fallopian tubes connect each of the two ovaries to the uterus. The egg released from the ovary moves through these tubes toward the uterus, and any present sperm also travels through the tubes, which is where fertilization of the egg normally occurs.
  • Tubal factor infertility occurs when the fallopian tubes are blocked due to diseases, damage, scarring, or obstructions that prevent sperm from reaching an egg for fertilization or prevent an embryo from reaching the uterus for pregnancy.
  • Tubal factor infertility is most commonly caused by pelvic inflammatory disease, sexually transmitted infections, or other conditions such as endometriosis.
  • The American Society for Reproductive Medicine (ASRM) says that 25% to 35% of female infertility is due to tubal factors.
  • Tubal factor infertility can sometimes be treated surgically to repair the tubes, depending on the degree of damage.
  • Women with tubal problems that cannot be surgically corrected or who do not want the surgery can undergo in vitro fertilization (IVF). This may include removing severely damaged tubes prior to IVF.

What is tubal factor infertility?

Tubal factor infertility occurs when the fallopian tube(s) prevents sperm from reaching the egg for fertilization or prevents a fertilized egg (an embryo) from reaching the uterus for pregnancy.

In the event that the fallopian tube is damaged, misshapen, or blocked in some way, a sperm, and an egg cannot meet, resulting in infertility. Alternatively, the tube’s damage may still allow fertilization of the egg and sperm but the embryo is unable to travel to the uterus and remains in the tube (ectopic, or tubal pregnancy).

The Female reproductive system

Blocked fallopian tubes

A tubal blockage is usually identified by its location as follows.

  • A tubal blockage located close to the uterus is called a “proximal” tubal blockage. ASRM reports that proximal tubal blockage makes up 10% to 25% of cases of tubal disease, which may be able to be treated relatively easily.
  • Mid-segment tubal blockage is in the middle of the fallopian tube and can be caused by some form of damage or scarring, which can occur from tubal ligation (having one’s “tubes tied”), ectopic (tubal) pregnancy, or the unsuccessful attempt of surgical reversal of sterilization (tubal ligation reversal).
  • A blockage that is located further from the uterus is called a distal tubal blockage. Fallopian tubes may be partially or completely blocked at their end.
  • Fimbriae are the finger-like fringes of tissue that help to sweep an unfertilized egg from the ovary into the fallopian tube. Damage to the fimbriae can prevent the egg from reaching the fallopian tubes.

Tubal factor infertility causes

The most common cause of tubal factor infertility is infection. Additional causes of blocking and scarring include:

  • Endometriosis, a disease in which the tissue that normally lines the uterus grows outside the uterus
  • Pelvic inflammatory disease (PID), an infection of the female reproductive organs
  • Sexually transmitted infections (STIs), most commonly chlamydia and gonorrhea
  • Ectopic pregnancy, a condition in which the embryo grows outside of the uterus, most commonly in the tube
  • Previous surgery

Patients have a higher risk of tubal factor infertility if they’ve had a ruptured appendix or previous abdominal surgeries, including surgeries for ectopic pregnancies. Due to the location of these conditions, tubal issues are more likely to occur.

Symptoms and diagnosis of tubal factor infertility

The main symptom of tubal factor infertility is the inability to become pregnant. Many women do not realize that they have fallopian tube damage until they have consulted a doctor for infertility.

In addition, when infertility is accompanied by signs of pelvic inflammatory disease, such as chronic lower abdominal pain, tubal infertility may be present. The two tests used to diagnose tubal factor infertility are a hysterosalpingogram and a laparoscopy.

Hysterosalpingogram (HSG)

Hysterosalpingogram is an X-ray in which a dye is passed through the cervix into the uterus. The dye can be followed through the fallopian tubes to see if they are open. It is important to note that if the tubes are open, it does not mean that they are functioning normally. There may be scarring or damage inside the lining of the tube that cannot be detected with this test.


Laparoscopy is a minimally invasive surgical procedure involving small incisions and the insertion of a small surgical instrument, called a laparoscope, to view the fallopian tubes. The laparoscope can determine whether or not the tubes are blocked or if there are other issues, such as scar tissue (adhesions), and allows the surgeon to attempt to repair the tubes.

IVF vs. tubal surgery

The opportunity to get pregnant and carry a fetus to term depends on age, co-existing fertility issues such as ovarian aging and male factor infertility, how bad the tubal damage is, where the tubes the blockage is located, and what type of surgery is used to correct the tubal condition.

The advantages and disadvantages of IVF and tubal surgery are something the patient and provider will discuss to assist decision-making.

A fertility specialist may recommend tubal surgery if the fallopian tube problem is the only fertility obstacle and the tubal damage is minimal. The downside of surgery is that it takes many weeks to fully heal, so there’s a delay in the pregnancy process.

The main advantages of IVF are good per-cycle success rates and the fact that it is less surgically invasive. IVF may be a likely option for women aged 35 or older, for those who have severe tubal damage, or if time is of the essence. The disadvantages include cost (especially if more than one cycle is required) and the need for hormone injections.


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Treating hydrosalpinx with IVF

If a woman has a hydrosalpinx, a form of tubal damage where the distal fallopian tube is blocked and fluid accumulates in the tube, the fluid may leak back into the uterine cavity from the fallopian tube. Even if a good embryo from IVF is placed into the uterus in a woman with hydrosalpinx, she has a much lower pregnancy rate because the fluid may wash the embryo away. It is for this reason that providers recommend removing or blocking the fallopian tubes so that the fluid does not leak back into the uterine cavity. This requires a surgical procedure.

Patient factors & risks to consider in choosing infertility treatment

Several patient factors should also be considered when choosing between surgery or IVF, including:

  • Age
  • Ovarian reserve (the number of eggs the patient has)
  • Prior fertility outcomes
  • Number of children desired
  • Site and extent of tubal damage including whether a hydrosalpinx is present
  • Presence of other infertility factors

Patient preference, religious beliefs, cost, and insurance reimbursement also figure into the equation. A semen analysis should be performed early in the infertility investigation, as these results may influence the decision between tubal surgery and IVF.

Patients opting for tubal surgery should know that these procedures increase the risk of scar tissue and adhesions. There is also a chance of recurrent blocked tubes after surgery, pelvic infection, or an ectopic pregnancy. The chance of conceiving naturally after surgery is greater if the patient is young and has a minimal amount of scar tissue blocking the fallopian tubes.

The most significant risks of IVF as a tubal treatment include the occurrence of multiples in pregnancy (twins or more, which carries risks for mother and babies) and ovarian hyperstimulation syndrome. This condition occurs when patients over-respond to fertility injections, which can lead to swelling of the ovaries and other severe symptoms including abdominal pain, vomiting, and shortness of breath. Overall, IVF is a very safe and effective fertility treatment for tubal infertility.

Tubal ligation in Voronezh – the price of surgical sterilization

✔ tubal ligation by video laparoscopic method;
✔ reliable and safe methods;
✔ irreversible method of contraception;
✔ quality anesthesia.

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Primary appointment (examination, consultation) with an obstetrician-gynecologist

1300 ₽

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Appointment (examination, consultation) of an obstetrician-gynecologist, leading specialist, primary

2000 ₽

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Reception (examination, consultation) of an obstetrician-gynecologist, chief specialist

3000 ₽

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Laparotomic tubal sterilization

6000 ₽

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Sterilization of fallopian tubes using video endoscopic technologies

12600 ₽

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Benefits of visiting the SOVA clinic:

✔ The latest diagnostic and treatment equipment.
✔ We use advanced techniques with guaranteed results.
✔ Comfortable hospital with round the clock medical supervision.
✔ Pre-registration without waiting and queues.

Sterilization (tubal ligation) is an irreversible form of female contraception. The essence of the surgical procedure is the artificial violation of the patency of the body, in which the fusion of the sperm with the egg becomes impossible. Anatomical blockade is performed by ligation using electrocoagulation.

The method is very reliable for those who need to avoid unwanted pregnancies. When prescribing an operation, it should be borne in mind that the consequences are irreversible.

One of the indisputable advantages of the technique is that the quality of life remains the same. After bandaging, the menstrual cycle does not change, sexual desire and libido are preserved.


Tubal ligation is prescribed in the presence of the following conditions:

  • repeated caesarean section or scar on the uterus after myomectomy;

  • have a history of cancer;

  • diseases of the cardiovascular system;

  • diseases of the endocrine, digestive, urinary or musculoskeletal systems;

  • pathology of blood and hematopoiesis;

  • congenital anomalies;

  • psychical deviations.

After 35 years, sterilization can be carried out at the request of the woman. To do this, it is necessary that a prerequisite is met – the presence of two or more healthy children. Before the procedure, a preliminary conversation is held. The doctor describes the upcoming stages, explains the pros and cons of the operation. The consequences are described in detail, which may differ in each case.

If there are medical indications, the patient signs an individual voluntary consent to the surgical intervention.


The limitations of the procedure include:

  • acute inflammation of the genital organs;

  • blood clotting disorders;

  • obesity II-IV degree;

  • severe pathology of the cardiovascular system;

  • some types of neoplasms on the genitals;

  • acute kidney and liver diseases;

  • pulmonary hypertension.

All contraindications are individual and are discussed with the doctor. The doctor makes a decision after a thorough assessment of the results of the study, anamnesis and the individual characteristics of the patient’s body.

If necessary, the surgeon will prescribe additional research methods, techniques of specialized specialists. Recommendations for proper home preparation are given on the eve of the intervention.

Sterilization at the SOVA Clinic

Surgical contraception is performed by various methods. A specialist should choose the right one.


Before the procedure, a comprehensive examination is carried out. It is necessary to pass a number of tests and undergo functional diagnostics:

  • general and biochemical analysis of blood, urine;

  • tests for HIV, syphilis, hepatitis;

  • ECG with interpretation;

  • smear from the genital tract and cervical canal;

  • examination by a gynecologist;

  • anesthesiologist consultation.

The intervention is performed under general anesthesia or epidural anesthesia with laparoscopic access.


Through small punctures in the abdominal cavity, endoscopic equipment and instruments are introduced. For better visualization of the surgical field, carbon dioxide is injected. Then the fallopian tubes are sealed using special devices, thereby blocking sperm from accessing the egg. At the end of the insertion site, the trocars are sutured with a cosmetic suture.

Among the advantages of this option, it should be noted:

  • short rehabilitation period;

  • minimal risk of complications;

  • after 2-3 days you can return to the normal rhythm of life.

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The following recommendations must be followed:

1. Give up physical activity for 1-2 weeks, until complete recovery.

2. Observe sexual rest in the first 10-14 days after discharge from the hospital.

3. Do not visit saunas, pools, baths. Do not take hot baths for 1 month. Wash in warm water at the optimum temperature.

4. There is no need to use additional methods of contraception.

The risk of complications is minimal. In the first hours after the intervention, pain in the abdomen is possible. To stop the symptom, take painkillers prescribed by a doctor.

If you experience non-specific complaints, you should consult a doctor.

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The success rate for tubal ligation is 99.9%. According to world statistics, conception occurs only in 5 out of 1000 women and only in cases where the procedure was performed incorrectly.

If the patient later decides to have a child, then IVF becomes the most affordable option. However, the effectiveness depends on many factors. In some situations, surgical treatment may be recommended.

Tubal ligation is performed once and is a guarantee to exclude unwanted pregnancy. This keeps the menstrual cycle going. The production of hormones goes at the same pace, so there is no danger of a decrease in sexual desire. The procedure does not affect the nature of the menopause.


Over the past 10 years, anesthesia and surgical techniques have been improved. Surgical sterilization has become the most reliable, safe and economical way to prevent pregnancy.

In the SOVA clinic, all surgical interventions are performed in modern operating rooms equipped with top-end equipment. In one place, you can quickly and comfortably undergo a preoperative examination, consult a doctor.

Recovery after surgical interventions takes place in a round-the-clock hospital under the supervision of specialists. Each room has a bathroom, air conditioning, TV and free Wi-Fi.

To make an appointment for tubal ligation, appointment with a specialist, call the call center or fill out the online form on our website. Administrators will help you choose a convenient time for a visit to the clinic, answer all your questions.

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Service provided:

st. Nikitinskaya, 52

7 (473) 373-03-03

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st. Nikitinskaya, 52

How to get there

7 (473) 373-03-03

Laparoscopic tubal ligation – Cost of surgery in Ukraine

At the doctor’s appointment for laparoscopic intervention

Contents of the page:

  • Advantages of the method
  • Indications and contraindications
  • Preparation for surgery
  • Operation progress
  • Rehabilitation period
  • Features of treatment in the clinic

Laparoscopic fallopian tube ringing to prevent pregnancy is an operation in which part of the fallopian tube is intercepted by a special ring, during which its patency is impaired, and pregnancy does not occur.

A woman refuses to get pregnant for various reasons. Each case has its own grounds for voluntary sterilization. There are also medical contraindications for pregnancy. These are severe chronic diseases in the stage of decompensation, a serious psychiatric pathology. In such cases, laparoscopic placement of rings on the fallopian tubes is used to prevent pregnancy.

This sterilization method compares favorably with other sterilization methods due to its reliability and reversibility. The use of temporary sterilization has undeniable advantages over permanent sterilization. The life situation can change, and a woman may want to give birth. That is why this technique is used in the Uzhgorod clinic of Bilyak.

Alternative methods have their drawbacks. Electrocoagulation of the tubes cannot guarantee complete occlusion of the lumen. The imposition of clips is also not reliable, since the clip can be damaged, as a result of which the patency of the fallopian tube is restored.

Crossing the tubes, crushing their ampullar section is an irreversible action, does not allow the resumption of the ability to give birth. The trauma of the intervention can provoke an adhesive process in the small pelvis.

Contacting the Bilyak clinic guarantees an individual approach and professional assistance to women who decide to give up children. Voluntarily or involuntarily, it doesn’t matter. The method used does not affect the state of health and leaves the possibility of pregnancy in the future.

Any questions regarding the prevention of pregnancy can be asked to a specialist of the Bilyak clinic using the service on the website.

Benefits of the

method First of all, it is worth mentioning that surgical sterilization provides the highest guarantee of contraception compared to other methods. It removes the functionality of the fallopian tube, which is the path for the egg that has left the ovary. It is here that fertilization occurs, and then the embryo passes into the uterine cavity. Tubal ligation completely eliminates the possibility of germ cells meeting and fertilization.

And yet, in some cases, when it comes to unsuccessful surgical interventions, fertilization does occur. And then the risk of developing an ectopic pregnancy is high. However, if the method of sterilization by applying rings is chosen, this danger is reduced to zero. It gives the lowest risk of complications, moreover, is reversible.

Fallopian tube rings have several advantages:

  • Maximum protection against unwanted pregnancy.
  • No effect on the state of the reproductive organs, female libido, hormonal levels.
  • Reducing the risk of inflammation of the appendages in the future – the path of infection into them is blocked.
  • Absence of injury – the tissues of the fallopian tubes are not damaged in any way, they are simply pulled by the ring.
  • Preservation of ovulation and the menstrual cycle.
  • Absence of complications and side effects.
  • Reversibility – the rings can be removed if desired, and the patency of the pipes is restored.

Many women choose to have this operation during a caesarean section. If this is not possible, laparoscopy is used. This technique compares favorably with alternative options:

  • Minimum time investment.
  • Absence of injury to muscle tissue and skin.
  • Reduced risk of complications.
  • Minimal blood loss.
  • Quick recovery.
  • Pronounced aesthetic effect.

Since laparoscopy does not require muscle dissection, the woman quickly recovers after it. And even if in the future she wants to reverse the consequences of the operation, remove the rings and become pregnant, there will be no obstacles to this. After all, the muscles of the abdominal wall are not injured, which means that she has every chance to endure and give birth to a child.

Indications and contraindications

Laparoscopic tubal ringing, if medically necessary, is performed in the following cases:

  • A woman over 35 does not want to become pregnant again, and she already has at least one child.
  • There are inflammatory processes in the pelvic organs, in which pregnancy is undesirable.
  • Conditions were diagnosed in which pregnancy and childbirth pose a danger to the patient’s life – decompensated diabetes mellitus, severe pathologies of the heart, kidneys, lungs, malignant tumors.
  • Serious genetic anomalies that are inherited.

The main indicator in which tubal ligation is performed is the desire and consent of the patient herself. But unfortunately, it is not always possible to carry out this operation. Contraindications to the imposition of rings are:

  • Severe obesity.
  • Inflammatory processes in the small pelvis.
  • Started adhesive process.
  • STD in the active phase.
  • Poor blood clotting.
  • Umbilical hernia.
  • Tumors of the genitals or intestines.

In any case, the decision to operate is made by the doctor after studying the patient’s history and carefully examining her.

Typical placement of trocars for placing rings on the fallopian tubes

Preparing for surgery

If a woman has made a conscious decision to abandon pregnancy (permanently or temporarily), laparoscopic sterilization is performed. This is a surgical intervention, so a number of clinical examinations are to be performed. The list of studies is small, you can go through them during the day. The list includes:

  • clinical and biochemical blood tests;
  • urinalysis;
  • tests for blood clotting, HIV and other viral infections;
  • cytological smear;
  • detailed interview and examination by a gynecologist;
  • Ultrasound of the pelvic organs, abdominal cavity and retroperitoneal space.

The data obtained helps to plan the upcoming laparoscopic application of rings on the fallopian tubes.

Our doctors undergo regular training in clinics in the USA and developed European countries. Modern equipment and the experience of surgeons make it possible to perform the intervention through three punctures in the abdominal cavity. But, nevertheless, this operation is performed under general anesthesia. Therefore, bowel preparation is required: hunger from the evening before the intervention, a cleansing enema before the procedure itself. On the day of the operation itself, it is also forbidden to eat and drink.

View of the ring for application to the fallopian tube (enlargement)


Laparoscopic prevention of pregnancy requires three punctures of the anterior abdominal wall, 10 mm and 5 mm in diameter.

A laparoscope is inserted into the area around the umbilicus. With its help, the surgeon examines the accessible areas of the abdominal cavity and small pelvis, and other trocars are installed under visual control.

Access to the fallopian tubes is provided, their middle section is displayed in the field of view. Then an applicator with a latex ring is inserted into the abdominal cavity.

The middle part of the fallopian tube is brought into the lumen of the applicator and a ring is put on it. As a result, a loop is formed, which the ring fixes. Upon completion of the manipulation, the pipe has the same appearance as in the figure below.

View of the fallopian tube after application of the anti-pregnancy ring

The same procedure is performed on the second fallopian tube. The light is completely covered. The ovary is not affected, the intervention does not affect the woman’s health.

After the rings have been placed, the trocars are removed. The punctures are either closed with adhesive bandages, or several stitches are applied to them. The procedure is completely bloodless and takes about 20 minutes.

If pregnancy becomes desired again, the ring is dissected laparoscopically and patency is restored, temporary sterilization is eliminated.

Rehabilitation period

Recovery after surgery is quite easy. The patient is allowed to get out of bed on the same day, and discharge is carried out after 1-2 days. After that, for 2 weeks you need to follow the precautions:

  • Replace bathing in a shower.
  • Eliminate physical activity completely.
  • Apply special complexes to prevent swelling and bleeding.
  • Refrain from sexual activity.
  • Eat a healthy diet.

In general, the majority of patients easily endure the operation and soon return to their usual way of life. The imposition of rings on the pipes does not affect the woman’s sexual desire and the ability to have fun. Also, this intervention does not cancel the possibility of motherhood in the future. And there are two options here. The first is to perform a laparoscopy again and remove the rings. The second is IVF. The patient herself chooses which option is more preferable for her.

Peculiarities of treatment in the clinic

Each case of visiting the clinic is individual. A harmonious approach to the treatment of any woman is a feature of the treatment process in our clinic. Our specialists respect the decision of the patient and do not dissuade from the operation. Moreover, the method of female sterilization offered in the Bilyak clinic does not cancel the possibility of motherhood in the future.

The special treatment of the staff is noticeable from the moment you ask for help. An individual nursing post is organized for each patient. Health is monitored by a qualified and experienced doctor. During her stay in the clinic, the woman’s condition is carefully monitored in order to exclude possible complications and immediately take measures in case of sudden bleeding, rupture, etc. But do not worry – such cases are rather an exception, because the sterilization method used here does not give complications.

The menu is compiled taking into account the individual characteristics of the patient’s body

The menu is compiled taking into account the individual characteristics of the patient’s body

The room is separate. Equipped in accordance with the standards adopted in the world’s leading clinics. This contributes to a quick recovery and improves the psychological mood of the patient – she feels more like in a hotel than in a hospital.

Special attention is paid to nutrition in the Bilyak clinic. The menu is compiled individually, taking into account the characteristics of the body of each patient. The composition of the dishes includes only organic products.

Ozone therapy is another progressive method used by Bilyak clinic specialists. Well-established schemes of this physiotherapeutic method of treatment contribute to the rapid restoration of strength and health after laparoscopic imposition of rings on the fallopian tubes.

Self-catering and movement is allowed after a few hours after the end of the procedure. An extract is possible already on the day of the operation, sometimes on the next. Thanks to the professionalism of the surgeons and the modern equipment of the clinic, the recovery period is not required! A woman only needs to follow the simple recommendations described above.

Service name Vartist, UAH
Laparoscopic tubal rings to prevent pregnancy 30000

Price includes full patient care during the standard period of stay in the clinic, namely:

  • medical and surgical support;
  • round-the-clock medical supervision;
  • individual nursing post;
  • dressings and all nursing procedures;
  • hospital stay;
  • food.

Please note! In other clinics of Ukraine, the above is not included in the price of the operation, but is paid additionally, and therefore the cost of surgical intervention increases significantly. Even dressings, injections, enemas, etc. are included in the surcharge.

Frequently Asked Questions

How much does Laparoscopic fallopian tube ringing to prevent pregnancy cost at Bilyak Clinic?

Laparoscopic imposition of rings on the fallopian tubes in order to prevent pregnancy in the Bilyak Clinic costs 30,000 UAH.

What is included in the cost of the operation?

The cost of the operation at the Bilyak Clinic includes the full provision of the patient, namely:
– surgical and medical support
– meals and accommodation
– 24-hour supervision of medical personnel
– dressings and all nursing procedures

Who performs operations and treats diseases in the Bilyak Clinic?

Operations in the Clinic of Bilyak are carried out by Ph.