The operation is usually done laparoscopically -which is commonly known as keyhole surgery. You will be asleep during the operation with a general anaesthetic given by needle into a vein. One or two cuts will be made into your abdominal wall and a gas piped into the abdomen in order to lift up the abdominal wall. A telescope will be put through one of the cuts and sterilising instrument through another.
The cuts will be closed, usually with a dissolvable stitch or sticky tape. Most women go home on the day of surgery. The wound should be kept dry for two days and the dressing can be removed after this time. You should continue to use your present contraceptive for at least one week after the operation.
General Risks Of A Procedure
(a) Small areas of the lungs may collapse, increasing the risk of chest infection. This may need antibiotics and physiotherapy.
(b) Clots in the legs with pain and swelling. Rarely part of this clot may break off and go to the lungs which can be fatal.
(c) A heart attack because of strain on the heart or a stroke.
(d) Death is possible due to the procedure.
(e) Increased risk in obese people of wound infection, chest infection, heart and lung complications and thrombosis.
(f) Increased risk in smokers of wound and chest infections, heart and lung complications and thrombosis.
Risks Of This Procedure
You have asked for a sterilisation operation. The sterilisation operation is intended to make you sterile. You should not have the operation if you are uncertain about whether you will want children in the future.
It should be assumed that this operation cannot be reversed. In some cases, it is possible to re- open the tubes. This
involves a long operation.
All contraceptive techniques, including sterilisation, have a failure rate. Pregnancies have even been reported after hysterectomy (removal of the womb).If the tubes are cut, the removed pieces of tubes will be examined under the microscope to prove sterilisation.
The risks and complications include:
(a) Accidental injury to the bowel, blood vessels and the urinary tract. Repair is usually possible at the time - often through the small cuts. It may also be necessary to make a larger cut to repair the bowel, blood vessel or urinary tract injuries.
(b) In case of bowel injury, it may be necessary for a temporary colostomy to allow the injured bowel to heal. This colostomy would normally be closed at a separate operation a few weeks later.
(c) Rarely gas, used to inflate the abdomen, can cause heart and breathing problems in 1 in 60,000 women. Death is a very rare risk.
(d) Future pregnancy. The failure rate of the two commonest laparoscopic sterilisations (filshie clip and fallope ring) is about 1 in 170 to 1 in 250 women who will become pregnant after female sterililsation. Pregnancy may also happen outside the womb (ectopic pregnancy) and may require emergency surgery. This is rare.
(e) If the operation cannot be completed through the laparoscope, then open surgery may have to be done. This will mean a larger cut above the pubis – about 5-8 cm, a longer stay in hospital and a longer recovery rate.
(f) Infection in the operation site in 1 in 250 to 1 in 1000 women. Treatment may be wound dressings and antibiotics.
(g) Burns on the skin due to use of electrical equipment in less than 1 in 100 women. These may take a few days to appear.