Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach
CPT4 code
Name of the Procedure:
Occlusion of fallopian tube(s) by device (e.g., band, clip, Falope ring) - Vaginal or Suprapubic Approach
Common Names: Tubal occlusion, Tubal sterilization, Tubal ligation
Summary
Tubal occlusion is a permanent method of birth control that involves closing off the fallopian tubes using small devices like bands, clips, or rings. This is usually done through a vaginal or suprapubic approach.
Purpose
This procedure is primarily performed to prevent pregnancy. By blocking the fallopian tubes, it keeps eggs from travelling from the ovaries into the uterus, where fertilization by sperm typically occurs.
Indications
- Desire for permanent contraception
- Medical conditions where pregnancy poses a high risk to the mother’s health
- Completed family planning
Preparation
- Patients may be advised to fast for 6-8 hours before the procedure.
- A pre-procedure consultation may include reviewing medical history, performing a physical examination, and possibly conducting blood tests or imaging studies.
- Instructions on medications to take or avoid before the procedure will be provided.
Procedure Description
- Anesthesia: General or local anesthesia is administered.
- Access: A small incision is made either in the vagina or just above the pubic area.
- Visual Assistance: A laparoscope (a small tube with a camera) may be used to view the fallopian tubes.
- Device Application: Small devices (e.g., bands, clips, Falope rings) are applied to the fallopian tubes to block them.
- Closure: The incision is closed with sutures or surgical adhesive.
Tools/Equipment:
- Laparoscope
- Band, clip, or Falope ring applicators
Duration
The procedure typically takes about 30 minutes to 1 hour.
Setting
This procedure is usually performed in a hospital or an outpatient surgical center.
Personnel
- Surgeon
- Surgical nurses
- Anesthesiologist
Risks and Complications
Common risks include:
- Infection
- Bleeding
- Pain at the incision site
Rare risks include:
- Ectopic pregnancy (where a fertilized egg implants outside the uterus)
- Injury to nearby organs
- Device migration or failure
Benefits
The primary benefit is effective and permanent contraception. Most patients can expect to see results immediately after the procedure.
Recovery
- Patients can often go home the same day.
- Pain management may include over-the-counter pain relievers.
- Normal activities can typically be resumed within a few days, but heavy lifting and strenuous activities should be avoided for about a week.
- A follow-up appointment may be scheduled to ensure proper healing.
Alternatives
- Hormonal birth control methods (pills, patches, injections)
- Intrauterine devices (IUDs)
- Barrier methods (condoms, diaphragms)
- Vasectomy for male partners
Pros and Cons:
- Pros of Alternatives: Non-permanent, fewer surgical risks.
- Cons of Alternatives: Less effective than permanent sterilization, require ongoing use, and may have hormonal side effects.
Patient Experience
- During the procedure, anesthesia ensures that patients are comfortable and pain-free.
- Post-procedure, patients may experience mild pain and discomfort at the incision site, which can be managed with medications.
- Emotional impacts of irreversible sterilization should be considered, and counseling may be beneficial.