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
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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

Patient preparation and premedication

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

Postoperative 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