Ligation procedure: Tubal ligation Information | Mount Sinai
Tubal ligation Information | Mount Sinai
Sterilization surgery – female; Tubal sterilization; Tube tying; Tying the tubes; Hysteroscopic tubal occlusion procedure; Contraception – tubal ligation; Family planning – tubal ligation
Tubal ligation is surgery to close a woman’s fallopian tubes. (It is sometimes called “tying the tubes.”) The fallopian tubes connect the ovaries to the uterus. A woman who has this surgery can no longer get pregnant. This means she is “sterile.”
Surgical sterilization which permanently prevents the transport of the egg to the uterus by means of sealing the fallopian tubes is called tubal ligation, commonly called having one’s tubes tied. This operation can be performed laparoscopically or in conjunction with a Cesarean section, after the baby is delivered. Tubal ligation is considered permanent but reversals can be done in many cases.
The ovaries are connected to the uterus by the uterine tubes (fallopian tubes). The egg travels through the tube to the uterus.
Tubal ligation is done in a hospital or outpatient clinic.
- You may receive general anesthesia. You will be asleep and unable to feel pain.
- Or, you will be awake and given spinal anesthesia. You may also receive medicine to make you sleepy.
The procedure takes about 30 minutes.
- Your surgeon will make 1 or 2 small surgical cuts in your belly. Most often, they are around the belly button. Gas may be pumped into your belly to expand it. This helps your surgeon see your uterus and fallopian tubes.
- A narrow tube with a tiny camera on the end (laparoscope) is inserted into your belly. Instruments to block off your tubes will be inserted through the laparoscope or through a separate small cut.
- The tubes are either burned shut (cauterized), clamped off with a small clip or ring (band), or completely removed surgically.
Tubal ligation can also be done right after you have a baby through a small cut in the navel. It can also be done during a C-section.
Why the Procedure Is Performed
Tubal ligation may be recommended for adult women who are sure they do not want to get pregnant in the future. The benefits of the method include a sure way to protect against pregnancy and the lowered risk for ovarian cancer.
Women who are in their 40s or who have a family history of ovarian cancer may want to have the whole tube removed in order to further decrease their risk of later developing ovarian cancer.
However, some women who choose tubal ligation regret the decision later. The younger the woman is, the more likely she will regret having her tubes tied as she gets older.
Tubal ligation is considered a permanent form of birth control. It is NOT recommended as a short-term method or one that can be reversed. However, major surgery can sometimes restore your ability to have a baby. This is called a reversal. More than half of women who have their tubal ligation reversed are able to become pregnant. An alternative to tubal reversal surgery is to have IVF (in vitro fertilization).
Risks of tubal ligation are:
- Incomplete closing of the tubes, which could make pregnancy still possible. About 1 out of 200 women who have had tubal ligation get pregnant later.
- Increased risk of a tubal (ectopic) pregnancy if pregnancy occurs after a tubal ligation.
- Injury to nearby organs or tissues from surgical instruments.
Before the Procedure
Always tell your health care provider:
- If you are or could be pregnant
- What drugs you are taking, even drugs, herbs, or supplements you bought without a prescription
During the days before your surgery:
- You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
- If you smoke, try to stop. Ask your provider for help quitting.
On the day of your surgery:
- You will most often be asked not to drink or eat anything after midnight the night before your surgery, or 8 hours before the time of your surgery.
- Take the drugs your provider told you to take with a small sip of water.
- Your provider will tell you when to arrive at the hospital or clinic.
After the Procedure
You will probably go home the same day you have the procedure. You will need a ride home and will need to have someone with you for the first night if you have general anesthesia.
You will have some tenderness and pain. Your provider will give you a prescription for pain medicine or tell you what over-the-counter pain medicine you can take.
After laparoscopy, many women will have shoulder pain for a few days. This is caused by the gas used in the abdomen to help the surgeon see better during the procedure. You can relieve the gas by lying down.
You can return to most normal activities within a few days, but should avoid heavy lifting for 3 weeks.
If you have the hysteroscopic tubal occlusion procedure, you will need to keep using a birth control method until you have a test called hysterosalpingogram 3 months after the procedure to make sure the tubes are blocked.
Most women will have no problems. Tubal ligation is an effective form of birth control. If the procedure is done with laparoscopy or after delivering a baby, you will NOT need to have any further tests to make sure you cannot get pregnant.
Your periods should return to a normal pattern. If you used hormonal birth control or the Mirena IUD before, then your periods will return to your normal pattern after you stop using these methods.
Women who have a tubal ligation have a decreased risk for developing ovarian cancer.
Isley MM. Postpartum care and long-term health considerations. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 24.
Rivlin K, Davis AR. Contraception and abortion. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 13.
Last reviewed on: 1/10/2022
Reviewed by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Tubal Ligation Procedure | Female Sterilization
In This Section
How effective is sterilization?
How safe is sterilization?
What can I expect if I get a sterilization procedure?
How do I get a sterilization?
What are the benefits of sterilization?
What are the disadvantages of sterilization?
What is sterilization?
Want to make sure pregnancy is not in your future? Sterilization (sometimes called female sterilization, tubal ligation, or “getting your tubes tied”) is a safe and effective surgical procedure that permanently prevents pregnancy.
What are the types of sterilization?
There are a few different types of tubal sterilization procedures:
Tubal ligation is a surgical procedure that permanently closes, cuts, or removes pieces of your fallopian tubes.
Bilateral salpingectomy is a surgical procedure that removes your fallopian tubes entirely.
Essure sterilization is a tiny coil that a doctor puts in your fallopian tubes to block them — it used to be a common form of sterilization, but Essure is no longer available in the U.S.
How does sterilization work?
Every month, an egg leaves one of your ovaries (called ovulation). The egg moves through one of your fallopian tubes for a few days, waiting for sperm to fertilize it. Pregnancy happens if a sperm cell meets up with one of your eggs, and the fertilized egg implants in your uterus. When your fallopian tubes are blocked or removed after a sterilization procedure, sperm can’t get to an egg and cause pregnancy.
During a sterilization procedure, you’re put to sleep so you won’t feel or remember anything. The doctor pumps gas into your belly so they can see your organs clearly. They make a small cut under your belly button and put a tiny camera inside your belly to find your fallopian tubes. Then they put a tool in through another small cut in your lower belly to close off your fallopian tubes. They’ll use heat, clips, or rings to seal your tubes shut, or remove your tubes altogether.
You still get your period after sterilization — you just can’t get pregnant because sperm can’t get to your eggs.
Is sterilization right for me?
Sterilization is permanent — you should only get sterilized if you’re totally sure you don’t want to be able to get pregnant for the rest of your life.
Sterilization may not be a good choice for you if:
There’s any chance you’ll want to get pregnant in the future.
You’re being pressured by your partner, friends, or family.
You hope sterilization will solve problems that may be temporary — like marriage or sexual issues, short-term mental or physical illnesses, or money problems.
It’s safe for most people to get sterilized. Your doctor will talk with you about your health and life to help you decide if sterilization is right for you.
Does sterilization protect against STDs?
Nope. Sterilization won’t protect you or your partners from sexually transmitted infections. Use condoms to help lower your chances of getting or spreading STDs.
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Costs up to $6,000, but can be $0
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Sterilization doesn’t protect you from STDs. Use a condom to help stop STDs.
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Ligation of hemorrhoids – prices for surgery, surgical treatment of hemorrhoids in “SM-Clinic”
How it works
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Ligation of hemorrhoids is a common procedure to treat hemorrhoids. The intervention is performed using special latex rings and can be used in the absence of symptoms of acute pathology.
In the chronic form of the disease, the technique has proven itself due to its high efficiency. Ligation of hemorrhoids stage 1 is not carried out. This is due to the fact that at this stage there are no formed nodes.
Ligation of hemorrhoids in “SM-Clinic” is:
Modern equipment and consumables
In our centers, we approach the choice of equipment, tools, and consumables as carefully as possible. This allows our specialists to achieve stability in the quality of service delivery, and patients to get the result they come to the doctor for.
The cost of this procedure at SM-Clinic is low, which means that such treatment will be affordable. If you have been diagnosed and ligation is recommended, contacting our doctors will help resolve this issue without delay (after all, the disease can progress without adequate medical care), and without hitting the family budget.
High speed problem solving
The intervention will only take about half an hour. Preparation for ligation is also short: in our centers it can be completed in 1 day. The use of high-tech equipment, the high qualification of doctors and the peculiarities of the technique make it possible to shorten the rehabilitation period and make it comfortable for the patient.
Purpose and indications for ligation of hemorrhoids
Ligation of hemorrhoids is carried out in order to quickly eliminate them without serious surgical intervention, pain and discomfort, as well as injury to healthy tissues.
The technique is recommended for internal hemorrhoids of the 2nd stage, for hemorrhoids of the 3rd stage it is used if it proceeds without complications. With external hemorrhoids, the method is not used, as it is not effective. In this case, the doctor recommends other treatment tactics.
Advantages of the method
Unlike a standard operation, the intervention is bloodless, safe and painless. It does not require anesthesia and long-term rehabilitation.
Special rings do not cause irritation, do not cause an allergic reaction and are not rejected by tissues. They are excreted from the body naturally when the node itself dies.
Important! The technique is effective in the case of mandatory elimination of factors that provoke hemorrhoids. These include a sedentary lifestyle, stagnant processes in the pelvic organs, a tendency to constipation and stress.
How is the ligation of hemorrhoids performed? 6
There are several options for ligation of hemorrhoids.
- Mechanical. With this treatment of nodes, a ligator with a long tube, a piston and a cylinder is used. The assembly is grasped by the clamp and pulled into the cylinder. Then the surgeon presses the trigger, and the piston pushes the ring against the leg of the node.
- Vacuum. For this procedure, a device is used that draws tissue using a vacuum. For this, a medical aspirator is connected to the ligator. When you press the trigger, the latex ring is reset. The level of pressure required is regulated by the surgeon.
During the procedure, the patient lies on his side. The area around the anus is pre-disinfected, an anoscope is inserted into the rectum. The required ring is selected in advance.
Preparation for surgery
A doctor’s consultation is required beforehand. The specialist answers all the patient’s questions about the features of the intervention, rehabilitation after it, etc. The patient also needs to pass a series of tests. Usually, a general blood test, a clotting test, a blood type, an Rh factor, and various infections are prescribed.
2-3 days before the procedure, the patient needs to give up drugs that thin the blood. If the patient is taking other medicines, they must be notified to the doctor. He will decide whether to continue or stop (temporarily) admission. A sigmoidoscopy is also performed. As part of such a diagnosis, the proctologist evaluates the condition of the rectum. On the evening before the intervention, a cleansing enema is performed. It is also possible to take special preparations that provide effective bowel cleansing.
Result of ligation of hemorrhoids
In addition to efficiency, the technique is relatively safe and affordable. It allows you to eliminate the unpleasant symptoms of the disease. In this case, it is desirable for the patient to change his lifestyle after the intervention. In this case, the likelihood of a relapse will be reduced.
An elastic latex ring will compress the leg of the knot and squeeze the vessels. This cuts off their blood supply. On the 10-12th day, the ring will be rejected along with the knot. At the site of rejection, connective tissue and a scar are formed, which will not affect the general health of the patient.
for a consultation with a proctologist
After the end of the main manipulations, a swab is inserted into the anus, which is pre-soaked with a special ointment with anesthetic. Also, the patient is prescribed anti-inflammatory and other drugs. They allow you to shorten the rehabilitation period and avoid unwanted side effects and complications. After 3-5 days, a control appointment is scheduled. On it, the doctor examines and interviews the patient. This allows you to evaluate the result of the treatment of hemorrhoids.
After the intervention, you should:
- Avoid constipation. For this purpose, the patient is prescribed a special diet. It excludes sweets and pastries, salty, spicy, fried and fatty foods. You should also give up milk, some fresh vegetables and legumes, carbonated drinks and alcohol.
- Drink plenty of fluids (at least 1.5-2 liters per day).
- Subject food to heat treatment.
- Eat cereals, fruit jelly, compotes.
- Avoid heavy lifting and sports.
- Sufficient time to devote to rest.
- Maintain good hygiene. Shower regularly and wear fresh underwear.
- Refuse thermal procedures (taking a bath, visiting a bath and sauna).
Important! All recommendations for a particular patient will be issued by a doctor. He will also determine the approximate time of rehabilitation and the period of restrictions. If necessary, a complex of necessary medicines will be selected.
Absolute contraindications to ligation of hemorrhoids are:
- Tendency to bleed. The patient needs to make sure in advance that the blood coagulation system is working properly and refuse to take aspirin and a number of other drugs (as agreed with the doctor).
- Mucosal changes. The intervention is not performed for anal fissures, proctitis, Crohn’s disease, fistulas, intestinal tumors.
- Allergy to latex products.
Intervention should be postponed in the presence of diseases such as diabetes, HIV infection, severe pathologies of the liver, kidneys, and heart. Do not perform the operation and with a combination of external and internal hemorrhoids.
In most cases, the intervention goes without complications. Some side effects can be caused by medical errors, so it is important to contact doctors with the necessary skill level. This will avoid complications.
Book an appointment with a specialist
Minimally invasive surgical interventions reduce the risk of complications and significantly shorten the rehabilitation period.
You can find out the details of the procedure, prices for ligation of hemorrhoids and sign up for a consultation with a specialist by phone:
+7 (495) 292-39-72
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Prices for ligation of hemorrhoids
Primary appointment (examination, consultation) with a coloproctologist
Ligation of 1 hemorrhoidal node