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Tubal Ligation

What is tubal ligation?

The procedure is performed to block, tie, cut, or remove  the fallopian tubes. There are various ways to perform the procedure.  It is considered a permanent method of birth control. Tubal ligations may be  performed at any time hysteroscopically in the office, laparoscopically in an outpatient surgery facility or operating room, or may be performed postpartum (after delivery) through a small incision below the navel. The procedure is typically minimally invasive, low risk, and involves a fairly quick recovery.

What is the Purpose of a tubal ligation procedure?

Tubal ligation is used as a permanent birth control method. This procedure should only be considered if you are confident you do not want to get pregnant in the future. Although this procedure is highly effective, the failure rate can be as high as 1 in 100 for certain methods of tubal ligation.  The failure rate is  much lower with the hysteroscopic (Essure) sterilization procedure. In addition, there is a higher risk of ectopic pregnancy (pregnancy outside the uterus) in the event that pregnancy occurs after a sterilization procedure.

How is the procedure performed?

There are a few different methods of tubal ligation.

Essure Hysteroscopic Sterilization- No incision and little to no anesthesia is needed for this procedure. It also has fewer failures than other forms of tubal ligation. The procedure is usually performed in the office, and usually in around 15 minutes. After placing a speculum, a hysteroscope is inserted through the cervix and into the uterus. An introducer  is used to place microinserts into each of the fallopian tubes. Natural scar tissue forms around the inserts.  After three months, a confirmation study is performed to verify that the tubes are blocked.  Women who have this procedure usually experience minimal to  no pain and are able to return to their daily lives immediately.

Laparoscopic tubal ligation-   One small incision is made in the navel. The gynecology surgeon will then use a viewing scope and surgical instruments to cut, clamp, cauterize, or remove the fallopian tubes. General anesthesia is required for this procedure.  There are more risks to this procedure compared to the hysteroscopic procedure and recovery may take a few days.

Postpartum Tubal Ligation- This procedure is performed soon after a woman gives birth. It is performed during this time because the fallopian tubes are located higher up in the abdomen due to the uterus being enlarged. The incision is made directly below the navel. The tubes are then cut and tied or cauterized. This procedure may be performed with an epidural or general anesthesia.

Open Tubal Ligation- A larger incision is made in the abdomen for this procedure. The tubes are then accessed, cut, clamped, tied or removed. Open tubal ligation is usually performed at the time of a cesarean section.


Recovery for tubal ligation depends on the procedure performed and the extent of the procedure itself. Hysteroscopic (Essure) sterilization results in the quickest recovery, followed by laparoscopic tubal ligation, and finally tubal ligation at the time of a cesarean section.  Women may experience cramping and spotting or light bleeding for a few days.

Gynecology and Laparoscopic Surgeons, PC provides tubal ligation surgery for patients in Raleigh, NC and surrounding areas. For more information about our gynecology services, contact us at our North Raleigh location.