Tubectomy

Tubectomy

The tubectomy procedure, also called tubal sterilisation, is a permanent method of contraception for women. It involves surgically blocking the fallopian tubes so that the egg the ovary releases cannot reach the uterus. Approximately 10 cm long tubes are attached to either side of the uterus. As part of the procedure, the tubes are sliced open, tied, or clipped at a particular point. It is a permanent method of birth control and sterilisation. A woman who wishes to avoid pregnancy or consecutive childbirth is likely to pursue this treatment.

Tubectomy is a major surgical procedure that’s irreversible and not without risks. CARE Hospitals are one of the most trusted gynaecology hospitals offering advanced surgical procedures under experienced doctors.  The department is staffed round the clock by experienced Obstetricians and can provide high-dependency obstetric care in the event of an emergency. 

We have well-equipped labour wards with intrapartum monitors, fetal care, and operational facilities within minutes of making a decision. In addition to obstetricians, the team is supported by cardiologists, haematologists, neonatologists, and intensive care specialists all under one roof.

In addition to oncosurgeons, we have colonoscopists who treat gynaecological cancers. We have specialists in laparoscopy, both diagnostic and operative, sonologists, neonatologists, neonatal surgeons, and geneticists who conduct specialised work in the field of foetal medicine.

Tubectomy indications

The tubectomy procedure is indicated for women who don't want to become pregnant in the future and request this permanent method.

The following factors should be considered by a woman who is considering permanent sterilization through tubectomy:

• The reasons for choosing permanent sterilisation.

• A tubal ligation might be the best option.

• Risks, complications, and side effects of the procedure.

• Alternative contraceptive methods if necessary.

Technique

Tuberculosis is a major surgery in which the fallopian tubes are cut open and clipped or tied up to prevent the passage of the egg into the uterus.

Types of Tubectomy

Tubectomy is primarily performed using laparoscopic techniques, as it minimizes scarring and allows the patient to go home on the same day. There are several approaches to perform tubectomy, including:

• Laparoscopy: A minimally invasive method used to diagnose or treat conditions in the pelvic region.
• Laparotomy: This involves performing a tubectomy during a C-section.
• Micro laparoscopy: Similar to laparoscopy, but uses smaller instruments.
• Mini-laparotomy: A less invasive version of laparotomy used for tubal ligation.
• Hysteroscopy: A vaginal approach for diagnosing or treating issues with pelvic organs.

To seal the fallopian tubes, two methods are commonly used:

• Electrocoagulation, which uses an electric current to clot the tube.
• Clip or band, which is placed around the tubes. In some cases, a device is used to separate the tubes from the ovaries and uterus, followed by tube removal.

Post Operative Care

After a tubectomy, patients are generally discharged the same day. Some common side effects include:

• Nausea and pain for 4-8 hours after surgery
• Fatigue and drowsiness
• Abdominal cramps and discomfort for a few days

Frequent check-ups with the surgeon are essential during recovery. The following post-surgery guidelines are typically recommended:

• Avoid strenuous activities and exercise for a week
• Refrain from sexual intercourse for at least a week
• Continue taking pain relievers until the discomfort from the sutures subsides

Procedure

A few small cuts are made around the belly button. During the procedure, a laparoscope is inserted through one of the cuts. In the laparoscope tip, there is an image-transmitting camera that transmits the images to a screen, allowing visibility of the internal organs to the surgeon. As the surgeon inserts the special instruments through the tiny cuts, he is guided by the images and seals the tubes by cutting parts of them or by blocking them using clips.

Different treatment methods:

• Bipolar coagulation: The fallopian tubes are steamed using an electric current.

• Monopolar coagulation: Electric current is used to seal the tubes. An additional radiating current is used to further damage them.

• Tubal clip: The fallopian tubes are permanently blocked by clipping or tying them together.

• Tubal Ring: A silastic band is used to tie the tube.

• Fimbriectomy- An ovary is connected to a section of the fallopian tube during this procedure. The result is a gap in the tube, which hampers the ability of the tube to receive eggs and transfer them to the uterus.

Recovery

After tubectomy, patients may be discharged on the same day. As a result of the surgery, one might expect:

• Pain and nausea during the first four to eight hours (short-term pain medication may be required)

• Cramps and pain in the abdomen

• Fatigue

• Dizziness

Usually, stitches are removed after a week or ten days. Following the surgery, a follow-up appointment with the surgeon is necessary.

Side Effects

Like any surgery, tubectomy carries certain risks and complications, including:

• Allergic Reactions: Some individuals may have an allergic reaction to anesthesia or other medications used during the procedure.
• Bleeding: In some cases, surgical instruments may cause injury, leading to excessive bleeding.
• Infection: If the incision site is not properly cared for, there is a risk of infection.
• Ectopic Pregnancy: Although tubectomy is a permanent form of contraception, there is still a risk of ectopic pregnancy, where the fertilized egg implants outside the uterus. If left undetected, this can become life-threatening.

CARE to be taken after Tubectomy

After surgery, it is important that you follow the surgeon’s instructions. Following are some tips for taking good care of yourself:

• For a week, avoid intense exercise.

• Your work can be resumed in a few days.

• Don’t have sex for a week after your tubectomy.

• Pain medication may help. However, if the pain is severe, you should consult a doctor.

• If you experience bleeding from the cut, high fever, fainting spells, etc., you should see the doctor right away.

Why is it so important to take these precautions before undergoing Tubectomy Surgery?

Sperms are alive in semen for 48 to 72 hours. The sperms would be inside the Fallopian tubes, which can fertilize the egg or ova if the woman had sex about two days beforehand. It is possible to become pregnant with this fertilised ovum even after a tubectomy if it is implanted inside the uterus.

In addition to the presence of viable sperms in the Fallopian tubes, there is another factor to consider. Although tubectomy may remove the sperms from the Fallopian tubes, they can still fertilise the ovum perceptibly trapped at the end of the tubes. In this case, the fertilized egg is unable to pass into the uterus, therefore, it will impregnate the thin Fallopian Tube resulting in an ectopic pregnancy. Ectopic pregnancy is a dangerous condition because it may lead to a ruptured Fallopian tube, severe haemorrhage, and sometimes even death if not detected in time.