Laparoscopic Tubectomy: Indications, Procedure, Advantages, Disadvantages, Complications, Contraindications

Tubal sterilization done as a minimally invasive procedure using a laparoscope, is called laparoscopic tubectomy. Let us understand more about laparoscopic tubectomy, its indications, tubectomy procedure, its advantages, disadvantages and complications.

Laparoscopic tubectomy is a surgery done for tubal sterilization using a laparoscope. This is performed under general anesthesia and lasts for about half an hour. Laparoscopic tubectomy is a minimally invasive surgery which involves obstruction of fallopian tubes so the transport of egg from ova is blocked. Laparoscopic tubectomy is the permanent method of sterilization. Tubal ligation can be performed either in the peripartum period or at any time from the pregnancy called as interval sterilization. It is usually performed during caesarean delivery or immediately in postpartum.

Some of the main indications of laparoscopic tubectomy include

• Permanent sterilization request by the woman
• Completion of child bearing potential of the woman.

Laparoscopic tubectomy is performed in a systematic manner. These investigations are mandatory to perform before laparoscopic tubectomy so as to avoid any complications.

• Urine pregnancy test – To rule out any pregnancy, as this surgery is contraindicated if the woman is pregnant.
• Urine analysis- To test for infections.
• Complete blood analysis- To check the blood make up and to identify any infections in the body, so as to plan appropriate treatment before the procedure
• Pelvic ultrasound – To check the pelvic internal organs and rule out any infections.
• Transvaginal sonography- To check for health status of the uterus, cervix, vagina, fallopian tubes and the ovaries.

While the instructions are properly given before the laparoscopic procedure, it is worth knowing the basic ones.

• Wear loose fitting clothing
• Overnight fasting the day prior to surgery for at least 6-8 hours
• Do not wear any jewellery
• Carry a sanitary pad as bleeding may be present later.

The procedure of laparoscopic tubectomy is explained to the woman and informed consent is taken. The abdominal cavity is filled with carbon dioxide gas so the uterus and tubes balloons away. The laparoscope is inserted with a small cut below the naval. One more small incision is made above the pubic hairline to allow another instrument which helps in closure of fallopian tubes. The tubes may be cut or clipped. The Falope’s ring or Filschie clips are placed to block the tubes. The skin incision is closed with one stitch or tape. The patient is observed in the outpatient recovery room and discharged after proper recovery.

Here are the post-procedure instructions after a laparoscopic tubectomy

• No drinking alcohol for at least 24 hours after surgery
• Removal of bandage the next day morning
• Bathing any time after surgery is allowed
• Women usually can return to work 3 days after surgery
• Sexual activity can be resumed one week after surgery

The main advantages of laparoscopic tubectomy include

• Rapid recovery,
• Easy access to Fallopian tubes
• Small incisions
• Rapid healing
• Outpatient surgery
• Short operating time
• Explore pelvic and abdominal cavity is possible.

Some of the disadvantages of laparoscopic tubectomy are

• Performed only under general anesthesia
• Risks of bowel injury

Like any surgical procedure, laparoscopic tubectomy too has certain risks and complications. Here are some of the possible complications of laparoscopic tubectomy,

• Incorrect anatomical site of sterilization
• Injury to internal organs
• Risk of requiring laparotomy
• Electrocautery complications
• Fallopian tube transection
• Uterine perforation
• Laceration of cervix
• Mortality

Laparoscopic tubectomy has many benefits and is one of the most preferred surgical procedure. However, for certain conditions, this may not be a good option, which must be noted before planning for the surgery. Some of the contraindications for laparoscopic tubectomy include

• Voluntary consent not given by the woman
• If the woman desires to bear a child
• Indications for hysterectomy
• Suspected pregnancy
• Active pelvic inflammatory disease
• Severe lung and heart problems

Laparoscopic tubectomy is usually a success leading to no pregnancy after tubectomy, but sometimes pregnancy happens due to faulty techniques namely incorrect anatomical site of sterilization.