McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is a therapeutic laparoscopy?

A therapeutic laparoscopy for tubal ligation is a procedure in which the doctor blocks a woman's fallopian tubes to prevent pregnancy. The fallopian tubes bring eggs to the uterus. The doctor uses a laparoscope (a thin metal tube with a light and tiny camera) to see the fallopian tubes. The doctor uses another thin tube with a cutting instrument to block them.

When is it used?

This operation may be performed because you have decided to have the fallopian tubes blocked to prevent future pregnancies. This operation is not necessary to treat a disease or an abnormal condition. It is performed only at your request. It may not be 100% successful in preventing pregnancies. It is very difficult to reverse this procedure if you want to become pregnant in the future.

Examples of alternatives are:

• trying other forms of birth control
• having your partner use birth control methods
• having abdominal surgery
• choosing not to have treatment.

You should ask your doctor about these choices.

How do I prepare for a therapeutic laparoscopy?

Your doctor may do a pregnancy test before the surgery.

Plan for your care and recovery after the operation. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow instructions provided by your doctor. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a general anesthetic, which relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.

Your peritoneal cavity will be inflated with carbon dioxide gas. This will expand your peritoneal cavity like a balloon and help the doctor see your organs. The doctor makes a small cut in or just below the belly button, puts a laparoscope into the abdomen, and puts another tool through a small cut in the lower abdomen. The scope is used to guide the other tool to your fallopian tubes. The doctor then burns or crushes the tubes closed with a clip or elastic band to prevent eggs from passing down them. Then, the doctor removes the scope and the tool and sews up the openings in the abdominal wall and belly button.

What happens after the procedure?

You may stay in the hospital several hours or overnight to recover. The anesthetic may cause a little sleepiness or grogginess for a while. You may have some shoulder pain, feel bloated, or find a change in bowel habits for a few days. You may not be able to urinate right away and may have a catheter (a small tube) placed into your bladder through the urethra (the tube from the bladder to the outside) for a few days. You should avoid heavy activity such as lifting. You should ask your doctor how much you should lift.

Ask your doctor what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

The fallopian tubes can be blocked without abdominal surgery, which has a longer hospital stay and recovery time. This may be a better form of birth control than other methods you have used before.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.
• After this operation, less than 1% of women still become pregnant.
• If you do become pregnant, you have a high risk of having a tubal pregnancy that requires surgery.
• The abdominal organs, glands, intestines, or blood vessels may be damaged. The doctor may perform abdominal surgery to repair them at the time of the laparoscopy.
• The lining of the abdominal wall may become inflamed.
• A blood clot may break off, enter the bloodstream, and clog an artery in the lung, pelvis, or legs. Rarely, a clot may break off and clog an artery in the heart or brain, causing a heart attack or stroke.
• You may develop an infection or bleeding.
• You may have some pain after the procedure.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.
• You become dizzy and faint.
• You experience nausea and vomiting.
• You become suddenly short of breath.
• You have abdominal pain or swelling that gets worse.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.