58670 Laparoscopy, surgical; with fulguration of oviducts (with or without transection)

Name of the Procedure:

Laparoscopy, surgical; with fulguration of oviducts (with or without transection)

Summary

This minimally invasive surgical procedure involves the use of a laparoscope to access and burn (fulgurate) the fallopian tubes to prevent pregnancy. It may also involve cutting and sealing the tubes (transection).

Purpose

Laparoscopic sterilization is performed to permanently prevent pregnancy. It is a form of permanent birth control suitable for women who are certain they do not want more children.

Indications

• Desire for permanent birth control
• Consideration as a contraceptive option when other methods are unsuitable
• Personal or medical reasons warranting permanent sterilization

Preparation

• Patients typically need to fast for 8 hours before the procedure.
• Preoperative evaluations may include blood tests, a pregnancy test, and a medical history review.
• Patients may need to adjust or temporarily stop certain medications as advised by the doctor.

Procedure Description

1. The patient receives general anesthesia.
2. A small incision is made near the navel, and the abdomen is inflated with gas to create space.
3. A laparoscope, a tiny camera, is inserted through the incision.
4. Additional small incisions may be made for inserting surgical instruments.
5. The surgeon locates the fallopian tubes and uses a device to deliver an electric current that burns and seals the tubes (fulguration). The tubes may also be cut and tied (transection).
6. The instruments are removed, and the incisions are closed with sutures or surgical tape.

Duration

The procedure usually takes about 30-60 minutes.

Setting

Typically performed in a hospital or outpatient surgical center.

Personnel

The procedure is conducted by a surgeon with support from a surgical team, including nurses and an anesthesiologist.

Risks and Complications

• Common risks: infection, bleeding, and adverse reactions to anesthesia.
• Rare complications: damage to surrounding organs, blood clots, and incomplete closure of the fallopian tubes leading to pregnancy.

Benefits

• High efficacy as a permanent method of birth control.
• Quick recovery time due to minimally invasive nature.
• Reduced risk of complications compared to traditional open surgery.

Recovery

• Patients can usually go home the same day.
• Post-procedure care includes rest, avoiding strenuous activities, and keeping the incisions clean and dry.
• Most patients recover fully within a week, although mild discomfort and bloating may be experienced.

Alternatives

• Other contraceptive methods include birth control pills, intrauterine devices (IUDs), and hormonal implants.
• Pros: reversible and less invasive options.
• Cons: less permanence and potential for higher failure rates.

Patient Experience

• During the procedure, the patient will be under general anesthesia and will not feel pain.
• Post-procedure, patients may experience mild pain, fatigue, and discomfort at incision sites.
• Pain management may involve over-the-counter pain relievers or prescribed medications.
• Supportive care and follow-up appointments help ensure a smooth recovery.