Laparoscopic Sterilisation
Indication
Sterilisation is a permanent method of Birth Control and should only be performed
when no further pregnancies are desired.
Anaesthetic
In the U.K. the procedure is generally performed under a general anaesthetic,
which means you will be asleep during the procedure.
Technique
The procedure is mostly performed by laparoscopy.
During the operation two small cuts are made on the tummy, one just beneath the
tummy button and the other just above the pubic bone. After gas is introduced,
a small telescope called a laparoscope is inserted into the tummy. This allows
the womb and tubes to be visualised.
Through the second cut an applicator is inserted which allows clips or rings
to be placed across the tubes. The clip or ring blocks the tube thereby preventing
the egg and sperm from reaching each other and so pregnancy is prevented. Eggs
not fertilised are small and are just absorbed by the body.
Length of Operation
The operation takes approximately 20 minutes.
Time in Hospital
Most procedures are carried out as a Day Case, which means you go home the
same day. If you suffer from other medical conditions you may need to stay in
hospital overnight.
Post op Discomfort / Limitations
There will be a little discomfort around the small incisions (cuts). Often
the surgeon will inject some local anaesthetic at the end of the procedure,
which helps. When this wears off all that should be required is some simple
analgesia like paracetamol.
You may have shoulder tip pain. This is caused by the carbon dioxide gas, which
was inserted during surgery. The pain lessens if you lie flat and disappears
as the gas is absorbed over the next 12 hours.
Time off Work
Allow a few days off work. You should be fit to drive again once the pain
has subsided.
Risks and Complications
Most of the time Laparoscopic sterilisation is a safe procedure but occasionally
complications do occur:
Risks of laparoscopy procedure:
- Anaesthetic- though generally very safe problems can occur with anaesthesia.
- Failure to perform the procedure laparoscopically – sometimes difficulties
can arise inserting the gas or instruments. If this were the case, the sterilization
procedure would be performed through a larger cut made along the bikini line.
This is more likely if you are overweight or have had previous pelvic surgery.
You will need to stay in hospital a few days.
- Permanent – the procedure must be considered permanent and most Health Authorities
will not fund sterilisation reversal except in exceptional circumstances.
Reversal of the procedure is however possible but more difficult than sterilization.
It is usually done through a bikini incision and the ends of the tubes stitched
back together using very fine stitches under microscopic magnification. The
hospital stay is about 5 days and recovery period about 6-8 weeks. With good
surgical skill success rates of 70-80% can be achieved.
- Failure – no method of contraception is 100% and that includes sterilization.
The procedure will fail 3 times in every 1000 procedures performed. This is
not usually due to the surgeon or materials used but due to the tubes re-opening.
Failures can occur years after the sterilization procedure has been performed.
- Ectopic pregnancy – (LINK – Ectopic pregnancy – own site) – when pregnancies
occur following a sterilization, these often occur in the tube. If your period
is late you should consider pregnancy and do a pregnancy test. If the test
is positive contact your general practitioner.
- Periods should remain unaffected by the operation. However if you have been
on the ‘pill’ prior to the sterilization, you may feel your periods are heavier
than before as the ‘pill’ has the effect of making your periods lighter.
- The operation should not change your feelings or emotions. For most women
sterilization provides peace of mind and this can lead to a happier sex life.
Outcome
For most women, sterilisation offers a safe and permanent method of Birth
Control.
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