Tubal ligation – types and best method of tubal ligation.

Definition 

Tubal ligation is a permanent form of female sterilization that involves cutting, sealing, or otherwise blocking the fallopian tubes to prevent fertilization and pregnancy. 

The procedure is usually performed as a surgical procedure, but can also be done using minimally invasive techniques such as laparoscopic or hysteroscopic methods. It is considered a safe and effective method of birth control but does not protect against sexually transmitted infections.

Types of tubal ligation 

There are several types of tubal ligation procedures, including:

Bipolar Coagulation

This is the most commonly used method in laparoscopic female sterilization and involves using an electrical current to seal sections of the fallopian tube. 

The resulting damage to the tube is typically only a few centimeters long, and the success rate of pregnancy after reversal is around 70%.

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Fimbriectomy

This method involves removing a portion of the fallopian tube closest to the ovary, which affects the ovary’s ability to pick up eggs. 

Reversing this procedure has low success rates, so in vitro fertilization is usually the preferred option.

Irving Procedure

This procedure involves placing two sutures around the fallopian tube and removing the section between them. 

The ends of the tubes are then connected to the uterus and connective tissue, leaving two healthy sections of the tube. This procedure has an average pregnancy success rate of 70%.

Monopolar Coagulation

Less commonly used than Bipolar Coagulation, this method uses an electrical current to cauterize the tube, which can also cause additional damage to the tubes as the current spreads. 

The fallopian tube damage from this procedure can result in a pregnancy success rate of around 45%, but if the tube length is still over 5 centimeters, the success rate can be up to 70%.

Tubal Clip

This method involves applying a permanent clip to the fallopian tube, which prevents the transfer of eggs to the ovary. Reversal and pregnancy success is highest with this procedure, with a success rate of up to 85%.

Tubal Ring

The Silastic Band or Tubal Ring technique involves folding the fallopian tubes over and applying a Silastic band to the tube. 

If only a small portion of the tube is impacted by the ring, the pregnancy success rate can be high.

Pomeroy Tubal Ligation

This type of tubal ligation involves strangling a loop of the tube with a suture. The loop is typically cut and the ends are cauterized.

This method, also known as cut, tied, and burned, is often good for reversal. 

The fact that the ends are burned is not a concern as that part will be lost during the tubal reversal anyway.

Essure

In this tubal ligation method, two small metal and fiber coils are inserted into the fallopian tubes. 

Scar tissue forms around the coils, blocking off the tubes and preventing sperm from reaching the egg.

Adiana

This tubal ligation technique involves inserting two small silicone pieces into the fallopian tubes. 

During the procedure, the healthcare provider heats a small part of each fallopian tube and inserts a tiny silicone piece into each tube. 

Scar tissue forms around the silicone inserts, blocking off the fallopian tubes and preventing sperm from reaching the egg.

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How effective are tubal clamps?

Tubal ligation, also known as permanent birth control, is considered safe and effective. 

However, it’s not foolproof and approximately 1% of women may still become pregnant within a year of the procedure. 

The younger a woman is when undergoing the procedure, the higher the likelihood of it not being effective.

Can tubal clamp reversed?

Tubal ligation, also known as having your tubes tied, is a permanent form of birth control. 

Reversing a tubal ligation is possible, but it is a surgical procedure and success rates vary. 

It’s best to discuss the options and chances of success with a doctor.

What is the best method for tubal ligation?

The best method for tubal ligation depends on the individual’s anatomy, medical history, and personal preferences. Common methods include:

Minilaparotomy: 

Small incision made in the abdomen to access the fallopian tubes

Laparoscopic: 

A minimally invasive procedure using a camera and small instruments

Essure: 

A non-surgical option that involves the placement of a small device in the fallopian tubes

What are the three methods of tubal ligation?

The best three methods of tubal ligation are: Minilaparotomy

Laparoscopic surgery

Essure procedure.

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