Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure)
CPT4 code
Name of the Procedure:
Ligation or Transection of Fallopian Tube(s), Abdominal or Vaginal Approach, Postpartum, Unilateral or Bilateral (Separate Procedure)
Summary
This procedure, commonly known as tubal ligation or 'getting your tubes tied,' involves the surgical blocking or cutting of the fallopian tubes to prevent pregnancy. It is performed shortly after childbirth, either through an abdominal incision or vaginally.
Purpose
The primary goal of this procedure is permanent contraception. It ensures the prevention of any future pregnancies by blocking the path of eggs to the uterus.
Indications
- Desire for permanent birth control
- Completed family planning
- Medical conditions where future pregnancies may pose a risk to the mother or fetus
Preparation
- Fasting for at least 8 hours before the procedure may be required, especially if general anesthesia is used.
- Preoperative blood tests and assessments to ensure patient suitability.
- An informed consent process explaining risks, benefits, and alternative options.
Procedure Description
- Anesthesia: Administered general or regional, depending on patient and procedure specifics.
- Incision: A small incision is made in the abdomen or, less commonly, through the vaginal route.
- Ligation/Transection: The fallopian tubes are located and either tied off (ligated) or cut (transected). Sometimes, a small segment is removed.
- Closure: The incision is closed with sutures or surgical glue.
Tools/Equipment:
- Scalpels, scissors
- Laparoscopic instruments (if minimally invasive approach)
- Sutures or surgical clips for sealing
Duration
Typically takes about 30 minutes to 1 hour.
Setting
This procedure is performed in a hospital setting, usually in the operating room or a specialized surgical suite.
Personnel
- Surgeon (usually an obstetrician/gynecologist)
- Surgical nurse
- Anesthesiologist
Risks and Complications
- Common: Pain at the surgical site, minor bleeding, and infection.
- Rare: Bowel or bladder injury, reactions to anesthesia, and ectopic pregnancy if the procedure fails.
Benefits
- Permanent solution to prevent pregnancy.
- Allows for more spontaneous sexual activity without contraceptive concerns.
- Minimal long-term side effects.
Recovery
- Usually, an overnight hospital stay is not required.
- Patients may experience some pain and swelling, which can be managed with pain medication.
- Avoid heavy lifting and strenuous activity for at least a week.
- Postoperative follow-up within a few weeks to check for complications and ensure proper healing.
Alternatives
- Long-term reversible contraception (IUDs, hormonal implants)
- Vasectomy (for male partners)
- Ongoing use of contraceptive pills, patches, or injections
Pros of Alternatives: Non-permanent, lower immediate risks Cons of Alternatives: Regular maintenance or compliance needed, potential for side effects
Patient Experience
- During the procedure: Under anesthesia, so no pain or awareness.
- Post-procedure: Mild to moderate pain managed with medication, some cramping, and minor bleeding.
- Pain management: Prescribed pain medications and recommendations for rest and limited activity.