Bilateral Tubal Ligation (BTL)

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.

How you prepare

Before you have a tubal ligation, your health care provider will likely:

• Review the risks and benefits of reversible and permanent methods of contraception
• Ask about your reasons for choosing sterilization and discuss factors that could lead to regret, such as a young age or marital discord
• Explain the details of the procedure
• Discuss the causes and probability of sterilization failure
• Share information about tubal ligation reversal
• Provide information about preventing sexually transmitted infections

If you’re not having a tubal ligation shortly after childbirth or during a C-section, you should use contraception for at least one month before the procedure and continue using contraception until your next period to decrease the likelihood of pregnancy. Having the procedure done during your period or during the days between your period and ovulation also reduces the chance of pregnancy at the time of the procedure. Your health care provider may give you a sensitive pregnancy test on the day of surgery to make sure you’re not pregnant.

Surgery

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 the Surgeon 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 “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.

After the procedure

If your abdomen was inflated with gas during the interval tubal procedure, the gas will be withdrawn. You may be allowed to go home several hours after the procedure. If you have the procedure in combination with childbirth, the tubal ligation isn’t likely to prolong your hospital stay.

You’ll have some discomfort at the incision site. You might also experience:

• Abdominal pain or cramping
• Fatigue
• Dizziness
• Gassiness or bloating
• Shoulder pain

You may take acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) for pain relief, but avoid using aspirin, since it may increase bleeding. You may bathe 48 hours after the procedure, but avoid straining or rubbing the incision for one week. Carefully dry the incision after bathing.

Avoid strenuous lifting and sex for one to two weeks. Resume your normal activities gradually as you begin to feel better. Your stitches will dissolve and won’t require removal. Check with your health care provider to see if you need a follow-up appointment

Risks of the procedure

Bilateral Tubal Ligation (BTL) is a relatively safe procedure. However; with all surgeries carry some risks. You will need to sign a consent form that explains the risks and benefits of the surgery.

• 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