Bilateral tubal ligation pros and cons

Tubal ligation is also a method of contraception. This method of contraception is very similar to sperm ligation for men, but female ligation will affect normal menstruation. Therefore, when the couple does not want to have children anymore, they should try to adopt the method of male ligation. Women are a vulnerable group, so they should be protected. So what are the advantages and disadvantages of bilateral tubal ligation?

The fallopian tube is the channel that transports eggs and is also the place where eggs and sperm combine for fertilization. Tubal ligation is a safe and permanent birth control measure that achieves the purpose of sterilization by cutting, ligating, electrocoagulating, clamping, or cuffing the fallopian tubes, preventing sperm and eggs from meeting. The surgical procedure can be performed transabdominally/laparoscopically or transvaginally.

1. Irving method

Its characteristic is that there is no vascular area in the isthmus of the fallopian tube; the fallopian tube core is ligated and cut, the proximal end is buried, and the distal end is free, the mesangium is basically intact, and the blood supply is not affected. The proximal end is buried in the mesangium, and the distal end of the tube is left outside the mesangium. The two broken ends are separated by serosa, and the chance of recanalization is extremely small. It is an ideal ligation method.

Use two tissue forceps to clamp the serosa at both ends of the isthmus of the fallopian tube, inject 1-2 ml of 0.5% procaine under the serosa to separate the serosa from the fallopian tube core, make a longitudinal incision of about 2 cm in the serosa at the injected bulge on the dorsal side of the fallopian tube, use two mosquito forceps to clamp the edges of the serosa opening, gently separate the serosa layer, clamp the two ends of the tube core with a clamp distance of 1.0 cm, remove about 0.5-1 cm of the fallopian tube core between the two forceps, ligate the two ends with No. 4 silk thread, bury the proximal end in the mesentery, suture the serosa incision intermittently with No. 1 silk thread, and suture the distal end with No. 1 silk thread to fix it outside the serosa.

2. Cuff ligation (Uchida method)

This method is roughly the same as the core-pulling embedding method. The characteristic of this method is that a circular incision is made in the serosa, the incision is small, and the operation is simple and easy.

In the isthmus of the fallopian tube, lift the serosa with mosquito forceps and inject 1-2 ml of 0.5% procaine under the serosa to separate the serosa layer from the core of the tube. Cut the serosa layer and the core of the tube together at the proximal end of the isthmus. The cut should not be too deep, and only the core of the tube should be cut to prevent tearing of the mesangium. The two broken ends of the tube core are clamped with mosquito forceps respectively, and another mosquito forceps is used to peel off the serosa to make it into a sleeve shape and separate it from the tube core. The tube core is peeled off about 1 cm, and the two ends are ligated respectively with No. 4 silk thread. The proximal tube core is retracted into the sleeve of the serosa, shaped like a "sleeve", and the distal tube core is exposed outside the serosa. Use No. 1 silk thread to suture the distal serosa layer 1 to 2 stitches to fix the exposed broken end outside the serosa.