27 July 2020 The tubal ligation is the interruption of the integrity of the fallopian tubes in order to prevent the fertilization of the egg by a sperm. Thus, the consequence of tubal ligation is the an impossibility of women of becoming pregnant naturally. For this reason, it is considered a permanent and hardly reversible method. Various approaches can be used to perform tubal sterilization: Laparoscopy; Minilaparotomy; Hysteroscopy; Tubal ligation can be performed simultaneously with a cesarean section. Tubal ligation by laparoscopy In the tubal ligation by laparoscopy, two small incisions are made in the abdomen, one in the navel area and the second near the pelvic bone. An optical system similar to a telescope is inserted through the navel incision and, through the same or the second entrance, can then be used: Coagulation systems for partial destruction of the tubes (bipolar, ultrasonic or laser energy); Systems for interrupting the continuity of the tubes, by placing clips or rings. Tubal ligation can be done during any other laparoscopic surgery. The procedure is done under general anesthesia. Tubal ligation by minilaparotomy The surgical approach of minilaparotomy is generally reserved for: Cases performed in the immediate postpartum period; When laparoscopy is contraindicated for medical reasons or has not been performed safely. Minilaparotomy implies a single and larger opening of the abdominal wall. Then, a tubal fragment is removed from each tube. This type of ligation can be performed during cesarean section or any other surgery by laparotomy. Anesthesia can be locoregional or general. Tubal ligation by hysteroscopy In the tubal ligation by hysteroscopy, the access is made through the vagina. Incisions are not necessary and small implants are placed in the tubes using a hysteroscope, a device that penetrates the uterus through the cervix. Each implant consists of an expandable metal part that causes the appearance of scar tissue that will clog the tube. This process requires about three months to be completed, so during this period and until an imaging exam is performed to confirm the normal positioning of the implants, another contraceptive method should be used. The tubal ligation by hysteroscopy is usually performed on an outpatient basis, under local anesthesia or without anesthesia. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
