Tubectomy (Tubal Ligation) in Hyderabad, India - Procedure Success Rate

Tubectomy procedures vary depending on the patient's health, the surgeon's experience, and the intended outcome. These techniques differ in terms of their strategy, invasiveness, and recovery time. The following are the most regularly utilized tubectomy procedures.

Laparoscopic approaches

Laparoscopy is the principal method for performing interval tubal sterilization treatments. It is not necessary to apply the same approach for both tubes. However, each fallopian tube must be totally or partially removed, or completely obstructed.

Bilateral salpingectomy

Laparoscopic bilateral salpingectomy is becoming the recommended method of tubal sterilization since it is associated with reduced risks of ovarian cancer and reduced surgical risk. Though long-term data are not yet available, bilateral salpingectomy is theoretically the most effective sterilization method. Furthermore, salpingectomy is frequently preferred when the tube is substantially aberrant.

Tubal occlusion procedures

Laparoscopic tubal occlusions are extremely similar to laparoscopic salpingectomy. An occlusive treatment focuses on the mid-isthmic tubal region rather than the tube itself. This narrowest section makes it the easiest and most efficient to occlude. Occlusion at the proximal isthmus, within 2 cm of the uterine cornua, poses a theoretical risk of fistula formation, but occlusion at more distal tubal segments is associated with higher contraceptive failure rates.

Open Approaches

Tubal sterilization can also be performed using an open method. If the patient has a cesarean delivery, tubal sterilization occurs immediately after the hysterotomy is closed and before the abdominal incision is closed. Following a vaginal delivery, tubal sterilization is usually performed via a small laparotomy under regional anesthesia. In addition, a small laparotomy may be performed in patients who are at high risk for laparoscopy or in places with limited laparoscopic facilities.

Parkland technique 

A Babcock clamp is used to raise the mid-isthmic part of the fallopian tube, creating a window in the avascular plane of the mesosalpinx beneath the tube. Two pieces of dissolvable suture (e.g., 0-chromic or plain gut) are threaded through this window and utilized to bind the proximal and distal ends of a 2- to 3-cm segment of the isthmic fallopian tube. The ligated tube portion is then removed sharply between the sutures. To ensure that the right anatomic component is resected, the tubal lumen should be visible within the tube's cut end.

Pomeroy method

The mid-isthmic part of the tube is elevated, allowing the proximal and distal ends to meet. A single strand of a fast absorbable suture (such as a 1-0 or 0 plain gut suture) is wrapped around both the proximal and distal sections of the tube, forming a loop or "knuckle" of the fallopian tube above the suture. If desired, a second suture can be inserted under the first. The tube portion above the suture ligation is then sharply removed. To ensure that the right anatomic component is resected, the tubal lumen should be visible within the tube's cut end. As the suture is absorbed, the proximal and distal ends separate from one another.

Hysteroscopic approaches

Previously, hysteroscopic tubal sterilization devices were available. The most common hysteroscopic sterilization device allows the practitioner to insert a tiny metallic coil into each fallopian tube. These coils subsequently triggered a local inflammatory response, resulting in scar tissue that clogged the tubes over the next few months. 

As a result, this treatment was not immediately effective and required a follow-up hysterosalpingogram three months later to achieve tubal closure. There is concern that these coils may increase the risk of chronic pelvic pain caused by perforation, coil migration, or nickel allergy. However, the evidence is equivocal, and the true association between coil placement and chronic pelvic pain remains unclear. As a result, women who have already had this treatment and have not had any bad effects may keep the device in place.

When it comes to permanent contraception, there are several surgical options to consider. One such procedure is tubectomy which offers a successful and long-term solution for people who have finished their family planning. The following are the main reasons why this surgery is indicated:

• Desire for permanent contraception: The main indication for tubectomy is the patient's informed desire for permanent contraception. This decision should be taken after carefully considering all available contraceptive options, including their efficacy and risks. Tubectomy is meant to eliminate future fertility, making it a good choice for women who do not wish to have any more children in the future. 

• Risk of pregnancy complications: In cases where pregnancy poses a considerable risk to a woman's health due to pre-existing medical issues, a tubectomy may be indicated to prevent future pregnancies.

• Postpartum sterilization: Tubectomy can be performed in the early postpartum period, especially following a cesarean delivery. This method is advantageous because it allows women who are currently undergoing surgery to undergo sterilization without having to undergo another treatment later. Because of its simplicity and effectiveness, it is widely accepted and practiced.

• Failure of other contraceptive methods: Women who have failed to use other forms of contraception may consider tubectomy as a more reliable option. This includes situations where hormonal techniques or barrier methods were not effective, resulting in unwanted pregnancies. 

• To prevent hereditary disorders: Women may choose to undergo tubectomy to prevent hereditary diseases, if anyone in a couple either the male or female has a genetic condition that they do not want to pass down to a child.
  

When considering the contraindications of tubectomy (tubal sterilization), it is critical to consider all the reasons that may impact a patient's decision to undertake this permanent form of contraception. Tubectomy is a major surgery, and understanding its limitations and contraindications is crucial for patient safety and satisfaction.

Some common tubal ligation contraindications may include: 

• Lack of informed consent: The absolute contraindication of tubal ligation is a lack of informed consent from the patient. Before continuing with sterilization, the patient must completely understand the procedure, its permanent nature, and other contraceptive choices.

• Severe obesity: Obesity may complicate tubectomy surgery. Obese women are more prone to the risks of general anesthesia than women with a normal BMI.

• Significant cardiopulmonary or renal disease: These conditions increase the risk of anesthesia. The laparoscopic method is also not recommended for patients with significant cardiopulmonary illness or dysfunction. The pneumoperitoneum can compress the vena cava and azygous system (network of veins), reducing cardiac return and leading to cardiac decompensation.

• Age and parity : Young age and low parity (few or no children) may not be considered absolute contraindications to sterilization, although caution and thorough counseling are recommended. In particular, the possibility of regret must be thoroughly emphasized to patients.

• Psychosocial factors: Patients who express uncertainty about their decision to have sterilization should be properly counselled on alternative contraceptive methods. If a patient exhibits evidence of coercion (against the patient's will) or pressure to have the treatment, it should be postponed until they can make an autonomous decision.

• Previous abdominal surgeries: A history of multiple abdominal or pelvic procedures may raise the likelihood of adhesions, complicating surgical access.

• Active infection: Any active pelvic infection should be managed before undergoing a tubal ligation to avoid the risk of postoperative complications such as infection or abscess formation.
  

Tubal ligation is considered permanent birth control and is approximately 99% effective in preventing pregnancy. If a person is certain that she does not want to become pregnant again, having the tubes tied is a safe and simple method of contraception.

Other advantages of tubal ligation include:

• High effectiveness: Tubectomy is a highly effective form of contraception, with a failure rate of less than 1% in the first year. This level of efficiency is comparable to that of long-acting reversible contraceptives, making it a reliable alternative for women desiring permanent sterilization. 

• Hormone free contraception: Unlike many contraceptive methods that rely on hormonal treatments, tubectomy offers a hormone-free option for women who may have medical contraindications to hormonal contraception or choose to avoid them because of negative effects. This makes it especially appealing for people who have had negative reactions to hormonal treatments.

• Reduced ovarian cancer risk: Tubectomy, especially when performed as a full salpingectomy (removal of the fallopian tubes), has been shown in studies to greatly lower the risk of ovarian cancer. Studies indicate that this approach can reduce the risk by 42% to 78%, which is especially important for women with genetic predispositions such as BRCA mutations. This preventive feature is increasingly recognized as an important advantage of the procedure.

• Reduced pelvic inflammatory disease (PID) risk: Tubectomy, by occluding or removing the fallopian tubes, minimizes the possibility of sexually transmitted infections climbing into the pelvic cavity, thereby reducing the risk of developing PID and its accompanying complications.

• Immediate effectiveness: Tubectomy provides instant contraception, reducing the need for long-term contraception methods like tablets or devices. This immediate effectiveness is beneficial for women who want to avoid unplanned pregnancies without delay.

• Improved quality of life: Some studies suggest that women who undergo tubectomy may report increases in quality of life in terms of sexual health and autonomy over reproductive decisions, particularly those at high risk for specific malignancies.
  

Where does the egg go after tubectomy (tubal ligation)?

After tubal ligation, the body absorbs the egg. Even if an ovum meets a sperm, fertilization may occur. Tubal sterilization prevents the passage of sperm through the fallopian tube. The ovaries continue to release eggs, which are then broken down and safely absorbed by the body. The ovaries are unaffected by sterilization.

Where is the block made in tubectomy (tubal ligation)?

During a tubectomy procedure, also known as tubal sterilization, the fallopian tubes that transport the oocyte are blocked to prevent eggs from reaching the uterus.

When to undergo laparoscopic tubectomy?

Laparoscopic tubectomy, also known as tubal ligation, is a permanent sterilization operation that can be performed at any time when a woman is not pregnant or during the postpartum period.

How much time would take for a tubectomy (tubal ligation) operation?

The actual surgery lasts for 30 minutes roughly. The surgeon will make one or more small incisions near the abdominal button. Sometimes the surgeon will make a minor incision in the lower abdomen as well.

Can I play sports after the tubectomy (tubal ligation) operation?

Following a tubectomy procedure, engaging in moderate physical activities have several health benefits, whereas excessive sedentary behavior, especial ly in regular exercisers, is harmful. Many doctors limit activity by following pelvic floor procedures, often for an indeterminate amount of time. The appropriate balance of exercise to support and maintain pelvic floor function in healthy people and those undergoing surgical procedures for pelvic floor diseases has yet to be determined.

Can a CT scan detect tubectomy (tubal ligation)?

Yes. A CT scan may identify tubal ligation, although it is not the ideal imaging tool to evaluate tubal abnormalities.

Is tubectomy painful?

Tubal ligation is performed as an outpatient procedure. It is safe and requires only a little recovery time. The operation may cause moderate pain, which can be managed with non-prescription or prescription pain medicines.

Can a tubal ligation be reversed naturally?

No, a tubal ligation cannot be reversed spontaneously. A tubal ligation is a permanent method of pregnancy control that includes cutting and tying the fallopian tubes. Reversing a tubal ligation involves extensive surgery to reattach the fallopian tubes, but the procedure is not always successful. However, general pregnancy success rates range between 40% and 85%.

Does tubal ligation cause weight gain?

No, tubal ligation, does not result in weight gain. Tubal ligation is a permanent birth control operation that does not influence the hormones or appetite.

What is Pomeroy tubectomy (tubal ligation)?

A Pomeroy tubectomy (tubal ligation) is a surgical technique used to prevent conception in women by closing the fallopian tubes. This is a partial salpingectomy. The pomeroy tubal ligation is a popular procedure for surgical female sterilization. The laparoscopic approach of Pomeroy tubal ligation employing endoloop sutures is often compared to the traditional technique of Pomeroy tubal ligation via Mini laparotomy.

Tubal ligation has been recognized as highly effective, with fewer than one in every 100 women becoming pregnant during the first year after surgery, indicating that tubectomy, also known as tubal ligation, is a permanent birth control technique with a success rate of more than 99%.

Can I get pregnant after tubectomy (tubal ligation)?

Yes, it is possible to become pregnant after a tubal ligation, although the chances are very low. Research states that even though tubal ligation is a safe and efficient method of pregnancy control, around one out of every 200 women may become pregnant following the procedure.

How to get an appointment for tubectomy (tubal ligation) surgery?

People in Hyderabad searching for 'Tubectomy Surgery near me' can conveniently schedule an appointment at PACE Hospitals. You can either complete the form above titled 'Request an Appointment for Tubectomy Procedure' or call our appointment desk at 04048486868.

Remember to bring your previous medical records, as these will help our specialists understand your medical history and deliver the best possible care for your Tubectomy surgery.