Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Ligation or Transection of Fallopian Tube(s) during Cesarean Delivery or Intra-Abdominal Surgery (not a separate procedure)
Summary
This procedure involves either tying off (ligation) or cutting and sealing (transection) the fallopian tubes. It is typically performed during a cesarean delivery or another type of intra-abdominal surgery and is not considered a separate procedure. Its primary purpose is to provide permanent birth control.
Purpose
The procedure addresses the need for permanent contraception in women who have decided not to have more children. The goal is to permanently prevent the eggs from traveling from the ovaries to the uterus, thereby preventing pregnancy.
Indications
- Women who have chosen permanent sterilization.
- Presence of other gynecological conditions necessitating cesarean delivery or abdominal surgery.
- Consultation and confirmed consent for permanent birth control.
Preparation
- Pre-operative consultations including informed consent about sterilization.
- Usual preparation for cesarean delivery or intra-abdominal surgery, such as fasting and medication adjustments.
- Antibiotic prophylaxis to prevent infection.
- Necessary diagnostic tests like blood work or imaging studies as required for the primary procedure.
Procedure Description
- Once the primary cesarean delivery or intra-abdominal surgery is underway, the fallopian tubes are accessed.
- The surgeon identifies the fallopian tubes and may use instruments such as clamps and special scissors.
- The chosen method (ligation or transection) is applied:
- Ligation: The fallopian tubes are tied with surgical threads (ligatures) to block them.
- Transection: The tubes are cut, and the ends are either cauterized or tied off to prevent rejoining.
- The surgeon ensures hemostasis (control of bleeding) and resumes or completes the primary surgical procedure.
Duration
This additional step takes approximately 10-30 minutes, depending on the complexity.
Setting
The procedure is performed in the operating room of a hospital.
Personnel
- Obstetrician-Gynecologist or General Surgeon
- Surgical Nurses
- Anesthesiologist or Nurse Anesthetist
Risks and Complications
- Infection at the surgical site.
- Bleeding.
- Injury to surrounding organs.
- In very rare cases, failure of the procedure leading to potential pregnancy.
Benefits
- Permanent birth control, eliminating the need for other contraceptive methods.
- Immediate contraception effectiveness following the procedure.
- Can be done without needing additional surgery if already undergoing a cesarean delivery or abdominal surgery.
Recovery
- The recovery is typically the same as for the primary cesarean delivery or intra-abdominal surgery.
- Post-operative care involves pain management, wound care, and monitoring for any signs of infection or complications.
- Usual recovery time ranges from 4-6 weeks.
- Follow-up appointments to check for healing and discuss any concerns.
Alternatives
- Long-term birth control methods such as intrauterine devices (IUDs), birth control pills, or hormonal implants.
- Pros: Non-permanent, reversible options available.
- Cons: May require ongoing maintenance and have different side effects.
Patient Experience
- During the procedure, patients will be under anesthesia and will not feel pain.
- Post-procedure, there may be some discomfort or pain managed with prescribed medications.
- Patients can expect to resume normal activities based on the recovery timeline for their primary surgery.