Sterilization by laparoscopy is a common procedure used to perform tubal ligation in women. Tubal ligation is a method of sterilization that involves obstruction of the fallopian tubes.
Laparoscopy enables the surgeon to complete tubal ligation by making a small incision near the navel. This smaller incision reduces recovery time after surgery and the risk of complications. In most cases, the woman can leave the hospital within hours after laparoscopy.
DIFFERENT TYPES ;
WHEN TO CHOOSE STERILISATION?
A woman should carefully weigh her decision to undergo sterilization .Though this procedure has been successfully reversed in some women, in almost all cases it causes a permanent loss of fertility.
Women who are unsure if they still want children should choose a less permanent form of contraception, such as birth control pills, an intrauterine device (IUD), or a barrier method (such as a diaphragm). Discuss these alternatives with your physician.
Your partner may also consider having a vasectomy, a method of male sterilization that involves severing and tying the vas deferens, a tube that transports sperm.
sterilization by laparoscopy provides a safe and convenient form of contraception. Once completed, no further steps are needed to prevent pregnancy. Tubal ligation also does not change a woman's menstrual cycle or cause menopause.
UNDER general anaesthesia ,A small incision is then made near the navel. A laparoscope, a thin viewing tube about the width of a pencil, is passed through this incision and the abdomen is inflated to make the organs easier to view.
A special device for grasping the fallopian tubes is inserted through a second, small incision The fallopian tubes are sealed with a band or clip that is placed over the tubes.
After surgery, patients stay in a recovery room and are observed for any possible complications. Patients are discharged generally same day, after they receive instructions for home recovery. Patients are asked for a follow-up appointment within7-10 days.
Recovery-Bandage can be removed the morning after the surgery. Steri-strips, which resemble tape, can be removed 2 to 3 days after surgery.
Patients can return to normal work 1 day after surgery.
Vaginal bleeding and menstruation
Vaginal bleeding/spotting up to 2-3 weeks after surgery is normal. Many women do not have their next normal menstrual cycle for 4 to 6 weeks after surgery. When your normal cycle returns, you may notice heavier bleeding and more discomfort than usual for the first two to three cycles.
You can resume sexual activity 3 week after surgery.
Is tubal sterilization reversal?
Reversal of the procedure is done in our centre by laparoscopic tubal recanalisation .
Laparoscopic technique .- of tubal reacanalization minimizes injury to delicate tissue in and around fallopian tubes and helps to ensure clear passage within the tubes for the sperm and the ovum.
This improved surgical technique has resulted in live births in 70-80% . The overall success in terms of intrauterine pregnancy after reversal of sterilization by microsurgery is about 60-80%
Laparoscopic technique for reversal of sterilization can provide better results than conventional surgery.
Although microsurgical reversal achieved 100% patency rate in our patients, certain factors, like duration of sterilization, technique of sterilization, and the length of the tube remaining after reversal, played a crucial role in deciding the pregnancy rate. Besides the magnification and atraumatic technique, tubal length > 4cm and time interval between sterilization and reversal of < 5 years resulted in better pregnancy rate.
Although the microsurgical technique has its own limitations, its proper application has brought a ray of hope to women seeking sterilization reversal like wishing to be pregnant after death of a child,or women opting for childbirth from second marriage.
What to be considered for women with failed tubal recanalization?
Women with severe fallopian tube disease who are not good candidates for tubal recanalization may consider IVF and embryo transfer as an alternative
Am I too old to undergo a tubal reversal?
it is important to understand that age is an important factor in predicting success following a tubal reversal procedure. Highest success is achieved when a tubal reversal is performed in women who are under the age of 40.
However, many women over the age of 40 have excellent ovarian reserve (strong functioning ovaries) and can be quite successful in achieving pregnancy following a tubal reversal.
Various tests can be performed to determine a woman's ovarian reserve prior to undergoing a tubal reversal. If it is determined that a woman's ovarian reserve is reduced, alternatives to tubal reversal, such as in vitro fertilization (IVF) can be offered.