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Bilateral Tubal Ligation

What is a Bilateral Tubal Ligation?

A Bilateral Tubal Ligation (BTL) is a surgical procedure that involves blocking the fallopian tubes to prevent the ovum (egg) from being fertilized. It can be done by cutting, burning or removing sections of the fallopian tubes or by placing clips on each tube.

When is it used?

A BTL is used when a woman wants to prevent pregnancy. It is considered a permanent form of birth control, although in some cases it can be reversed. There can be damage to the tubes after reversal, so this decision should not be made quickly.

How do I prepare for a BTL?

You will have this procedure in the outpatient surgery center or in the main hospital if you have just delivered a baby. You will not be able to eat or drink anything after midnight the day before your surgery. This procedure is done laparoscopically or immediately following a cesarean section. If you are taking any medications, you should discuss these with your doctor to see when you should stop them.

What happens during the procedure?

You will be given general anesthesia which will put you to sleep. One incision will be made in the umbilicus (belly button) and three small incisions will be made in the lower abdomen. Gas is pumped into the abdomen in order to help Dr. Hardy see the uterus, ovaries and fallopian tubes. A laparoscope is a telescopic instrument that is used to locate the fallopian tubes. Once the tubes are exposed, a small section of each tube is cut free and removed. The severed ends are ligated &ldquldquo;burned” with a cautery tool or clips may be placed on each tube. The skin is closed with sutures that will dissolve and steristrips on the outside that may be removed after 1 week.

What happens after the procedure?

You will be moved to the recovery room while the anesthesia is wearing off. Your pain will be controlled with pain medications and any side effects will be addressed. You will be able to go home that day if you were scheduled for an outpatient surgery. If you have this procedure done after delivery, you will be discharged according to your postpartum care.

You may experience pain that radiates to your shoulder. This is caused from the gas that was used during the procedure. You may use an electric heating pad, drink warm beverages and walk to help alleviate this pain. You may bathe and shower as usual. You may wash the incision gently with mild unscented soap.

You will be given prescription pain medication to use for 2 to 7 days after the procedure. A stool softener may also help alleviate or prevent constipation. You will be given 2 weeks to recover from the procedure. Avoid sex or exercising until your postoperative appointment. You may resume driving after you are not taking any narcotic pain medication

What are the benefits of this procedure?

You do not have the risks associated with hormones for birth control.

You have a more permanent form of birth control.

What are the risks associated with this procedure?

Some of the risks associated with a BTL are:

  • Inadvertent injury to surrounding structures including the bowel, bladder, uterus, ovaries.
  • Infection or bleeding
  • Complications from anesthesia
  • Allergic reaction to any medications used during and after the procedure
  • Failure of sterilization procedure which is less than 1% which may result in an ectopic (tubal) pregnancy

There are people who have a higher risk of complications which are:

  • Obesity
  • Smoking
  • Poor nutrition
  • Recent or chronic illness
  • Use of drugs such as antihypertensives, muscle relaxants, tranquilizers, sleeping pills, insulin, sedatives, beta-adrenergic blockers, or cortisone
  • Use of mind-altering drugs including narcotics, psychedelics, hallucinogens, marijuana, sedatives, hypnotics or cocaine

When should I call the office?

Call the office right away if:

  • You have heavy bleeding from your uterus (you need more than 1 pad or tampon per hour or the bleeding is heavier than your menstrual flow).
  • You develop a fever over 100°F (37.8°C).
  • You develop headache unrelieved with Tylenol, ibuprofen or narcotic pain medication, muscle aches, dizziness or a general ill feeling.
  • You have severe abdominal pain or abdominal pain that continues even after you take acetaminophen or aspirin.
  • You have pain, swelling, redness, drainage or bleeding increases in the surgical area
  • You experience nausea, vomiting, constipation or abdominal swelling or other unexplained symptoms.