Laparoscopic Sterilisation

What is a laparoscopic clip sterilisation?

Laparoscopic clip sterilisation is a minor surgery where metal clips are used to block the fallopian tubes providing a permanent contraception solution. The clips stop eggs from the ovaries from travelling to the uterus and also block the meeting of the sperm from the egg so there is no fertilization resulting in a pregnancy.

Laparoscopic clip sterilisation procedure

Laparoscopic clip sterilisation is a simple one-day case procedure carried out under general anaesthesia. A laparoscope (a thin telescope) is inserted into the abdomen through a small incision made just below the belly button. Carbon dioxide gas is pumped into the abdomen to separate the tissues allowing clear visibility of pelvic organs. A small cut is made near the pubic hair line and metal clips are used to clamp the fallopian tubes through this incision.

Why is laparoscopic clip sterilisation necessary?

Laparoscopic clip sterilisation is a suitable form of contraception that the patient considers after thoroughly evaluating all available options.

What possible complications are associated with laparoscopic clip sterilisation?

The surgery has a failure rate of 1:500 with an increased risk of ectopic pregnancy. It is possible that the surgeon encounters difficulties caused due to a previous pelvic surgery or the patient is overweight in which case a slightly larger cut is made requiring a longer stay in the hospital.

As with any surgery there is always a risk associated with general anaesthesia but risks specific to laparoscopic clip sterilisation include perforation of the organs of the pelvis including the uterus, bowel or bladder.

Preparing for the operation?

It is important that your decision for laparoscopic clip sterilisation is taken after necessary due diligence and in a rational state of mind and not something under force or emotional stress such as marital stress or recent childbirth. Be absolutely sure that you do not wish to beget a child anytime in the future due to various circumstances such as divorce/ remarriage, death of a child etc.

What will having a laparoscopic clip sterilisation involve?

Prior to surgery

You will be advised to abstain from eating/ drinking after 12:00 midnight. You would also need to remove jewellery (except wedding rings or accessories difficult to remove). Also remove nail varnish from finger and toe nails and shower or bath the night or morning before the operation.

Admitting yourself to the hospital

Please inform your attendant if you are nervous or are suffering from a cold or fever. Do ask questions if any. You will be advised to change to a hospital gown and walked to the trolley or operation theatre by the nurse.

After the operation

You could have some period-type cramps, abdominal bloating and also experience shoulder tip pain due to accumulation of wind. You would be given painkillers to address this. In case you experience nausea, you could be administered anti-sickness injections or tablets. Once you have passed urine you could return home and slowly begin consuming liquids and solids. Ensure you have a relative/ friend to stay with you overnight as also to escort you home when you are allowed to return.

On going home

Take plenty of rest. If you experience pain you would be advised paracetamol tablets but take care to restrict this to 6-8 tablets in 24 hours. Your pain would be manageable in this period but if you find it is not subsiding, do check with your doctor for advice. You should not experience any rise in temperature post surgery but if you do, contact your doctor on priority for advice. A little blood is common from the wounds for up to 24 hours and a dry dressing or plaster could be applied if required. Resume bathing as soon as you can but do not apply soap or powder on the wounds. Stitches if any will dissolve within two weeks.
If they don’t or the area becomes reddish or tender, please contact your doctor.

Will I suffer from constipation after my laparoscopy clip sterilisation?

This is unlikely although a reduced fluid and diet intake can cause slight constipation. Do eat a healthy diet consisting of fruit and vegetables and drink lots of fluids.

When can I resume normal activities?

You could resume normal activities as soon as you feel better – usually within 72 hours. Avoid lifting of weights/ strenuous exercises until you feel fit/ comfortable.

From when can I resume exercising again?

You could begin exercising after a week. Just take it easy and get to your regular intensity over a period of time gradually. Do not push yourself on this.

Will I have a scar?

Since the incisions made are very small, scars will barely be visible after a few months.

How long will I continue to experience tiredness?

You will experience tiredness for up to a week following surgery. You can gradually resume duties as you feel fit and improve in terms of alertness and stamina.

When will I be able to resume regular sexual activity?

You may have light vaginal bleeding for up to a week and once this settles down and you have no pain you could resume sexual activity. It is advised that you go for a pregnancy test in case there is a delay in your period. The failure rate of the surgery is 1:500 and there is a risk of ectopic pregnancy. Women may feel a sense of regret for their lost fertility which could result in reduced libido.

Should I continue to have cervical smear tests?

Yes, these tests are advisable. The surgery does not alter your need for regular cervical smears.

Would I require Hormone Replacement Therapy (HRT)?

Not right away. This decision would be made in consultation with your doctor when you enter menopause.

Would I experience a low feeling?

This is not an expected outcome of the surgery although initial discomfort and restriction of usual activities may affect you initially. This should resolve itself over a period of time.

Will my ovaries continue to produce eggs?

Yes, your ovaries will continue to produce eggs which will be reabsorbed by the body. Your menstrual cycle would also continue. However if you were previously on the Pill, you may discover your periods are heavier.

When do I need to visit the hospital after my laparoscopic clip sterilisation?

You would be advised to see the doctor one week after surgery for a check-up and further advice.