Difference between revisions of "Tubal ligation"

Tubal ligation
Anesthesia type	GA vs. neuraxial
Airway	ETT vs. LMA
Lines and access	20G PIV
Monitors	Standard
	Primary anesthetic considerations
Preoperative	Full stomach precautions in postpartum patients
Intraoperative
Postoperative
	Article quality
Editor rating	In development
User likes	0

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Revision as of 12:05, 14 March 2022

A tubal ligation is a surgical procedure for female sterilization that involves severing and tying the fallopian tubes. Most are done laparoscopically, but at times it is performed during a C-section while the uterus is externalized. Some are done 8 hours post-partum. Recently, a transcervical method has emerged which can be performed in the doctor's office.

This procedure is 99% effective in the first year, but fallopian tubes can rarely reform or reconnect. Of those failures, 15-20% of pregnancies are likely to be ectopic.

Preoperative management

Patient evaluation


System	Considerations
Airway
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

Operating room setup

Patient preparation and premedication

Timing can be intrapartum (during C-section) or at least 8 hours postpartum

Regional and neuraxial techniques

Intraoperative management

Monitoring and access

Induction and airway management

Positioning

Maintenance and surgical considerations

Emergence

Postoperative management

Disposition

Pain management

Potential complications

Bleeding
Infection
Damage to bowel, bladder, major vessels
Prolonged abdominal or pelvic pain

Procedure variants


	Laparoscopic	Mini-laparotomy	Post-Partum	Transcervical
Anesthetic	GA/ETT or spinal (T4 sensory block)	GA/ETT or spinal (T4 sensory block)	Epidural, spinal, or GA	GA/LMA
Position	Supine	Supine		Lithotomy, may need slight Trendelenburg
Surgical time	15-45 mins	15-45 mins		In office, usually 30 mins
EBL	Minimal	Minimal	Minimal	Minimal
Postoperative disposition				Home
Pain management
Potential complications

References

Top contributors: Olivia Sutton and Chris Rishel

@@ Line 1: / Line 1: @@
+{{Infobox surgical procedure
+| anesthesia_type = GA vs. neuraxial
+| airway = ETT vs. LMA
+| lines_access = 20G PIV
+| monitors = Standard
+| considerations_preoperative = Full stomach precautions in postpartum patients
+| considerations_intraoperative =
+| considerations_postoperative =
+}}
+A tubal ligation is a surgical procedure for female sterilization that involves severing and tying the fallopian tubes. Most are done laparoscopically, but at times it is performed during a C-section while the uterus is externalized. Some are done 8 hours post-partum. Recently, a transcervical method has emerged which can be performed in the doctor's office.
+This procedure is 99% effective in the first year, but fallopian tubes can rarely reform or reconnect. Of those failures, 15-20% of pregnancies are likely to be ectopic.
+== Preoperative management ==
+=== Patient evaluation<!-- Describe the unique and important aspects of preoperative evaluation. Add or remove rows from the systems table as needed. --> ===
+{| class="wikitable"
+|+
+!System
+!Considerations
+|-
+|Airway
+|
+|-
+|Neurologic
+|
+|-
+|Cardiovascular
+|
+|-
+|Pulmonary
+|
+|-
+|Gastrointestinal
+|
+|-
+|Hematologic
+|
+|-
+|Renal
+|
+|-
+|Endocrine
+|
+|-
+|Other
+|
+|}
+=== Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. --> ===
+=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> ===
+=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> ===
+* Timing can be intrapartum (during C-section) or at least 8 hours postpartum
+=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. --> ===
+== Intraoperative management ==
+=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===
+=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===
+=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===
+=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===
+=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===
+== Postoperative management ==
+=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===
+=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===
+=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===
+* Bleeding
+* Infection
+* Damage to bowel, bladder, major vessels
+* Prolonged abdominal or pelvic pain
+== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==
+{| class="wikitable wikitable-horizontal-scroll"
+|+
+!
+!Laparoscopic
+!Mini-laparotomy
+!Post-Partum
+!Transcervical
+|-
+|Anesthetic
+|GA/ETT or spinal (T4 sensory block)
+|GA/ETT or spinal (T4 sensory block)
+|Epidural, spinal, or GA
+|GA/LMA
+|-
+|Position
+|Supine
+|Supine
+|
+|Lithotomy, may need slight Trendelenburg
+|-
+|Surgical time
+|15-45 mins
+|15-45 mins
+|
+|In office, usually 30 mins
+|-
+|EBL
+|Minimal
+|Minimal
+|Minimal
+|Minimal
+|-
+|Postoperative disposition
+|
+|
+|
+|Home
+|-
+|Pain management
+|
+|
+|
+|
+|-
+|Potential complications
+|
+|
+|
+|
+|}
+== References ==
+[[Category:Surgical procedures]]