Laparoscopy Tubal Ligation or tubectomy is a surgical procedure used to block the transfer of ova through the fallopian tube and prevent the pregnancy or implanting the ova into the uterus
Indication
Birth control plans
To control the pregnancy to avoid the risk of severe disease like chronic kidney disease, heart disease, etc.
Tubal ligation requirements
General Instruments
#15 scalpel with #3 BP handle
Artery forceps
Allis forceps
Adson tissue holding forceps
Needle holder
Kidney tray
Bowl sponge holder
Laparoscopy instruments
10mm trocar port
5mm trocar port
J tip laparoscopy suture
Dermabond/Steristrips for skin closure
Babcock forceps
Metzenbaum scissors
Maryland forceps
Light source cable
Gas tube for insufflation with CO2 insufflator
Position
Patients positioned in lithotomy position for laparoscopy tubal ligation procedure
and followed by Trendelenburg position
Anesthesia
General anesthesia
1 % lidocaine local infiltration of local anesthesia drugs on the surgical site of incision
Tubal ligation surgery
Incisions made on the abdomen with the #15 scalpel handle and dissect with artery forceps.
Using Verre’s needle, create the pneumoperitoneum using CO2 insufflator
Introduce the trocar by grasping the muscle together while insertion
Camera port ready for the insertion of a telescope with camera for visualization
Make one more incision for the working channel
A surgical assistant from the perineal site drains the bladder and lift the uterus using the uterine manipulator
The surgeon once differentiated the fallopian tube and check for adhesion and dissection starts with a monopolar hook if needed
Use the atraumatic Babcock forceps for lifting the fallopian tube and clip or use the O ring to achieve the blockage of the tube
Read more about Tracheostomy
Tubal ligation types and methods
- Dissection and ligation method
- Fallopian O ring method
- Filchie clip method
Dissection and ligation
Just cut the fallopian tube after the clamping and ligate it using bipolar forceps.
Fallopian O ring method
The ready-made ring made of silastic material for the application on the loop of the fallopian tube. The ring applicator itself creates the loop by manual action and application of O ring achieved.
After the ring applied, the fallopian tube site necrosis starts and blockage of fallopian is achieved without fails
Make sure the clip applied tight and proper manner after application
Filchie clip method
Clip application in between of fallopian tube using clip applicator. The clip must be applied on the two sites leaving a 0.5mm gap for ligation
After application of the clips, cut with the Metzenbaum scissors for cutting the tube in between the clips applied
The clips applicator used to apply the clip made of absorbable material.