Ligation: tubal ligation surgery

Ligation is the interruption of the fallopian tubes for definitive contraception. In the fallopian tubes, the ovum meets the spermatozoa (fertilization). The obstruction of this canal prevents fertilization or fertilization, making it impossible for the woman to become pregnant through this route. Currently, there is a "tube stent" (similar to a spring) that is placed by ambulatory hysteroscopy, without anesthesia with the same function of obstructing the tube.

Lung failure in 2.3 to 16.5 women in every thousand five years after the procedure. After 10 years, the number increases to between 3.7 and 24.8 women failing for every thousand who did the procedure. The clips stay may fail at 31.7 to 36.5 of women in a thousand and the "stents" may fail in 96 cases per 1,000 in 10 years. The number of post-procedure regrets is high

Other names

Tubal ligation or Definitive Voluntary Surgical Contraception

Indications

This procedure is for the woman or couple who opts for definitive contraception, that is , female sterilization for patients who can not become pregnant due to risk of death or do not want to become pregnant.

If salpingectomy is done (removal of the fallopian tube), the procedure may help prevent ovarian cancer. Tubertal stent placement may also protect against pelvic infections.

Contraindications

• Disease or clinical conditions that contraindicate surgery and / or anesthesia
• Infections that contraindicate a stent placement
• Not being pregnant
• Not complying with Family Planning Law 9.263 / 96 *.

Exams necessary to perform surgery

Preoperative routine exams for surgeries, with anesthesiologist's assessment and specific that the surgeon deems necessary :

• Cardiology evaluation in patients with cardiac problems
• Pregnancy test
• Gynecological clinical examinations
• Cytology (Papanicolaou)
• Research for gynecological infection
• Pelvic ultrasound

Pre-procedure care

• A free and informed consent form must be signed and be within the articles of Law 9.263 / 96 on Family Planning *
• Psychological evaluation of the patient and cas
• Discuss and observe medical advice regarding continuous and sporadic medications
• Fasting of eight hours prior to surgical procedures

How is it performed

Tubal tubal ligation comprises a number of techniques in relation to the procedure and can be made by several accesses such as: open abdominal (by abdominal incision or laparoscopy), vaginal and by hysteroscopy.

According to the access route, the patient will be in a position different for adequate exposure of the fallopian tubes. It can be used: general anesthesia, blockage (spinal) with or without sedation and, if the stent is placed, there is no need for anesthesia.

If there is an abdominal incision, it can be made periumbilical post- immediate caesarean delivery, when there is a risk to the life or health of the woman or the future concept, witnessed and signed by two doctors. Also incisions may be made above the pubis (mini, where possible, longitudinal or transverse incisions of + or - 3 cm).

In case of laparoscopy, routine periumbilical incisions and two lateral incisions are used. To facilitate the exposure of the fallopian tubes, a uterine manipulator may be used, and apparatus for attaching an elastic ring, metal clip, stitches, or cautery.Vaginal and hysteroscopic procedures have no scar. Tubal exposure is made by the vagina and the tubal stent placed by hysteroscopy, that is, by means of a flexible rod with a light and a camera at the tip, which projects the image on a screen and helps the medical team to see the tubes of the patient, performing the procedure.

Which doctor performs surgery

All medical specialties qualified to do the procedure. If it is by laparoscopy, it must be a gynecologist with a specialization in this procedure, as well as for hysteroscopic surgery the professional must have training to place a "stent tube."

Procedure duration

The average duration of the procedure depends much of the technique and skill of the surgeon. On average, around 40 minutes.

In cases of complications such as adhesions and bleeding, the procedure may take longer.

Length of stay

The patient may leave after one day of hospitalization or may

Care after surgery

Recovery is rapid and with relative rest in the first few days. Care depends on the approach, but the main one is the surgical wound. The doctor will guide you in the return when you can return to active sexual life and exercises. In the case of tubal stents, an interval of three months must be observed for fibrosis and occlusion of the tubes. During this period, an effective contraceptive method should be used.

Possible Complications / Risks

Like any other surgeries there are risks and complications such as: bleeding, infections, injuries to other organs etc. Specifically related to the procedure may occur: pain, cramps, pain during intercourse, abnormal uterine bleeding due to altered ovarian vascularization, ectopic pregnancy (out of the womb), etc.

About 3 to 25% of women regret

Some patients blame sterilization as the basis for other problems such as: weight gain, loss of libido, depression, separation, etc.

Regulation

She is approved by CFM, Anvisa, Ministry of Health and Gynecology Societies. We must emphasize that all sterilization must follow the norms of Law 9.263 of 1996 * - Family Planning with integral health care. We highlight the main points:

Art. 10. Voluntary sterilization is only permitted in the following situations:

I - in men and women with full civil capacity and over 25 years of age or at least two live children, provided that the minimum period of 60 days between the manifestation of the will and the surgical act, a period in which the person concerned will be offered access to a fertility regulation service, including counseling by a multidisciplinary team, to discourage early sterilization;

Only surgical sterilization the institutions that offer all options for reversible methods and methods of contraception.

The SAS / Ministry of Health 48/99 extends the prohibition until the 42nd day after delivery or abortion.

Pregnancy may increase risk of stroke in young people, says research

The results compared the incidence rates of stroke among pregnant and non-pregnant women of different age groups. "Although stroke is a rare event in young women, 18% of all strokes in women under the age of 35 were associated with pregnancy. In contrast, among older women of childbearing age, 1.4 % of strokes were associated with pregnancy, "said the study led by Eliza Miller, of Columbia University.

(Health)

Angelina Jolie says she has already been diagnosed with Bell's palsy

Angelina Jolie said in an interview to Vanity Fair magazine, which was diagnosed with Bell's palsy, a paralysis that causes half of the face to appear to be drooping or drooping, causing weakness in the facial muscles. This condition can affect anyone of any age. The exact cause of Bell's palsy is unknown, but is believed to be the result of a swelling or inflammation of the nerve that controls the muscles on one side of the face.

(Health)