Bilateral Tubal Ligation (BTL)

Bilateral Tubal Ligation (BTL)

A Bilateral Tubal Ligation (BTL) is a surgical procedure that involves blocking the fallopian tubes to prevent the ovum (egg) from being fertilized. It can be done by cutting, burning, or removing sections of the fallopian tubes or by placing clips on each tube.

FAQS

Frequently asked questions about surgical procedures

What’s not included:

• Lab testing before and after the surgery, as needed
• Electrocardiogram (EKG), depending on age. If you had one elsewhere in the past 6 months and it read “normal”, we can forego this expense.
• Imaging costs. X-rays and MRIs can be obtained anywhere.
• Physical therapy services
• Medications you’ll need (oral or IV antibiotic infusions if an infection arises)
• Wound care
• Bracing supplies
• Additional doctor visits (a pre-operative visit with the surgeon, in person, and any required post-op follow-ups after the suture removal to monitor your progress
• Additional surgical intervention if a complication arises
• Additional imaging or hospital care if a blood clot develops

How you prepare

Before you have a tubal ligation, your health care provider will likely:

• Review the risks and benefits of reversible and permanent methods of contraception
• Ask about your reasons for choosing sterilization and discuss factors that could lead to regret, such as a young age or marital discord
• Explain the details of the procedure
• Discuss the causes and probability of sterilization failure
• Share information about tubal ligation reversal
• Provide information about preventing sexually transmitted infections

If you’re not having a tubal ligation shortly after childbirth or during a C-section, you should use contraception for at least one month before the procedure and continue using contraception until your next period to decrease the likelihood of pregnancy. Having the procedure done during your period or during the days between your period and ovulation also reduces the chance of pregnancy at the time of the procedure. Your health care provider may give you a sensitive pregnancy test on the day of surgery to make sure you’re not pregnant.

Surgery

You will be given general anesthesia, which will put you to sleep. One incision will be made in the umbilicus (belly button,) and three small incisions will be made in the lower abdomen. Gas is pumped into the abdomen in order to help the Surgeon see the uterus, ovaries, and fallopian tubes. A laparoscope is a telescopic instrument that is used to locate the fallopian tubes. Once the tubes are exposed, a small section of each tube is cut free and removed. The severed ends are ligated, “burned” with a cautery tool, or clips may be placed on each tube. The skin is closed with sutures that will dissolve and steristrips on the outside that may be removed after 1 week.

After the procedure

If your abdomen was inflated with gas during the interval tubal procedure, the gas will be withdrawn. You may be allowed to go home several hours after the procedure. If you have the procedure in combination with childbirth, the tubal ligation isn’t likely to prolong your hospital stay.

You’ll have some discomfort at the incision site. You might also experience:

• Abdominal pain or cramping
• Fatigue
• Dizziness
• Gassiness or bloating
• Shoulder pain

You may take acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) for pain relief, but avoid using aspirin, since it may increase bleeding. You may bathe 48 hours after the procedure, but avoid straining or rubbing the incision for one week. Carefully dry the incision after bathing.

Avoid strenuous lifting and sex for one to two weeks. Resume your normal activities gradually as you begin to feel better. Your stitches will dissolve and won’t require removal. Check with your health care provider to see if you need a follow-up appointment

Risks of the procedure

Bilateral Tubal Ligation (BTL) is a relatively safe procedure. However, all surgeries carry some risks. You will need to sign a consent form that explains the risks and benefits of the surgery.

Inadvertent injury to surrounding structures, including the bowel, bladder, uterus, and ovaries.
Infection or bleeding
Complications from anesthesia
Allergic reaction to any medications used during and after the procedure
Failure of the sterilization procedure, which is less than 1%, may result in an ectopic (tubal) pregnancy

How are follow-up and initial consultations handled?

In-person and telehealth consultations are possible with the surgeon to whom your case is assigned. The initial visit is included in the surgical package and is valued at $375.
We can also obtain the flights from the volunteer pilot nonprofit if you’d like to come for initial and follow-up visits in person. One follow-up visit is included in the surgical package at a value of $175. Any additional visits are charged at the time of service to your credit or debit card.