Last updated date: 18-Aug-2023
Originally Written in English
A woman can become pregnant by transferring an egg from her ovaries through the fallopian tube, which connects the uterus and ovaries. One or both fallopian tubes are removed during a salpingectomy, which sterilizes women. Without this structure, getting pregnant naturally without in vitro fertilization is practically impossible.
Usually, the fallopian tubes are removed laparoscopically, which involves making small incisions and using a camera to view the abdomen. Compared to a short laparotomy, which only requires the surgeon to make a few inches of an incision to conduct the procedure, this is less invasive. For a laparoscopic method, it is often an outpatient treatment, and if the operation is done, it will be an inpatient procedure with a brief hospital stay. Except in cases of ectopic pregnancy, this procedure is typically not an emergency.
Bilateral Salpingectomy Approaches
Laparoscopy or open abdominal surgery can both be used by your doctor to do a salpingectomy. Each procedure has advantages and disadvantages. Your doctor will decide which method is best for you after considering your age, medical history, and planned fertility timeline.
Abdominal Bilateral Salpingectomy
Making a big incision in the lower abdomen allows the surgeon to see the pelvic organs properly and remove the fallopian tube tissue during abdominal surgery.
Any abdominal surgery usually has a lengthier recovery period and a higher potential for complications including tissue damage or infection. However, abdominal surgery may be chosen if the fallopian tube and surrounding tissue have experienced significant damage or if a sizable tumor needs to be removed.
Laparoscopic Bilateral Salpingectomy
A laparoscope is inserted into the pelvis through one of the tiny cuts the surgeon makes in the lower abdomen during this less invasive salpingectomy surgery technique. The surgeon is guided through the surgery by the camera at the end of the laparoscope. After that, the tiny incisions are used to remove the fallopian tube tissue.
In general, laparoscopic surgery is less traumatic and leaves you feeling better faster. Not all patients, though, will make suitable laparoscopic surgery candidates. Sometimes a surgeon will start an operation laparoscopically only to discover that it would be better to finish it abdominally.
Bilateral Salpingectomy Indications
In the United States, 25% of women of reproductive age utilize female sterilization as a form of contraception, making it the most widely used method of contraception in the world. This translates to around 600,000 surgical sterilizations carried out yearly in the US.
There are numerous explanations why a doctor could advise having your fallopian tubes removed. These include contraception, cancer prevention, and the need for treatment for specific cancers or in the case of an ectopic pregnancy.
- Contraception. When both fallopian tubes are removed, the eggs no longer have a way to travel and cannot go to the uterus to be fertilized. The fallopian tubes cannot be restored once they have been removed. This is therefore an irreversible, permanent method of birth control. Before choosing this procedure, you should give your future reproductive health considerable consideration. Before performing this irreversible treatment, make sure you and your spouse or partner are on the same path.
- Ectopic pregnancy. The fertilized egg leaves the uterus and implants itself somewhere else in an ectopic pregnancy. Frequently, this issue is a medical emergency. To avoid rupture and potentially fatal hemorrhage, the fallopian tube may need to be removed when the egg implants there.
- Prevention of cancer. Cancer cells that form in the fallopian tubes and subsequently migrate to the ovaries are thought to be the source of ovarian cancer. If your risk of developing ovarian cancer is very high, some doctors may advise the removal of both fallopian tubes to lower your risk. To eradicate all malignant and worrisome cells from your body, some types of cancer may be managed by removing one or both fallopian tubes, often together with other reproductive organs.
- Other reasons. A salpingectomy may also be necessary in cases of infection and endometriosis. Your doctor might advise the removal of one or both fallopian tubes due to further gynecological issues or health factors.
Bilateral Salpingectomy Contraindications
Because of the permanent nature of this form of sterilization, the woman's age and if she already has biological children are taken into account. This technique might not be possible due to prior operations or health issues like morbid obesity, but your surgeon will decide on that.
A partner's pressure or times of extreme stress, such as those following a miscarriage or divorce, should not be used as an excuse to undergo surgical sterilization. According to research, women who decide to have the operation for sterilization while they are younger than 30 are more likely to regret it.
Purpose of Bilateral Salpingectomy
Patients will receive a pregnancy test, a Pap smear, a sexually transmitted diseases screening, and ultrasonography if there are any suspected pelvic masses before surgery.
When treating gynecologic cancer or other medical disorders, this operation may be done in conjunction with the removal of other female organs for the goal of sterilization. Surgery is one method of making a cancer diagnosis in people who are thought to have ovarian or uterine cancer.
The surgeon will determine if all of the pelvic organs (uterus, ovaries, and fallopian tubes) need to be excised depending on the patient. Samples of the lymph nodes will also be collected during surgery. To find out if cancer has migrated from one location to the nearby tissues, they will be evaluated in a lab.
When an egg fertilizes in a fallopian tube and develops into an implant in the tube rather than the uterus, this condition is known as an ectopic pregnancy. This requires single fallopian tube removal.
Complete fallopian tube removal reduces the risk of developing ovarian cancer later in life compared to tubal ligation (burning, banding, or clipping the fallopian tube and leaving it behind).
Bilateral Salpingectomy Preparation
Your doctor's office will schedule this operation in advance. Salpingectomy surgery for sterilization is viewed as an elective because there are other options to avoid getting pregnant.
Surgery is required in cases of suspected cancer since it is one of the initial measures in treating gynecologic cancer. You should plan on missing work on the day of the surgery, and you could need one or more days to heal before going back to your job.
A surgical team consisting of a surgeon, resident, physician assistant or nurse practitioner, surgical nurses, scrub nurse, and anesthesia team to observe the patient under general anesthesia performs a salpingectomy in a hospital surgery room or outpatient surgery facility.
The night before the procedure, the patient will be instructed by the surgeon to avoid eating or drinking after midnight. Except as advised by the surgeon, some drugs can be given with tiny sips of water. Otherwise, nothing else should be eaten.
On the day of surgery, patients should give the surgeon a complete list of any current drugs they are taking, as well as any adjustments or missed doses. The surgeon will decide whether it is best to keep taking drugs that increase bleeding or discontinue them.
Any prescribed medications, over-the-counter drugs, dietary supplements, vitamins, or illicit drugs must be mentioned to your surgeon. As the hospital can be cold on the day of surgery, it's crucial to wear comfortable shoes, pants, and possibly a sweater or jacket.
On the day of the procedure, bring your insurance cards and a valid ID. You'll need a support person to drive you from the hospital to your house. Due to the anesthetic drugs administered during the surgery that would make it unsafe for you to drive, you will be unable to do so.
As with any operation, quitting smoking is essential before surgery since it increases the risk of postoperative surgical site infections, delayed wound healing, and other healing issues. To reduce complications, it is advised to cease smoking at least four weeks before surgery.
Give yourself additional time the day of the salpingectomy to find parking and find the hospital's operation check-in area. To give the pre-surgical staff enough time to get you ready for surgery, you should check in at the scheduled arrival time.
Before the Surgery
On the day of the procedure, a nurse will check your vital signs, weight, pregnancy status (if appropriate), and blood sugar level (if applicable) in the preoperative area. Patients will take off all of their jewelry and clothing before changing into a surgical patient gown. Consent forms for anesthesia and surgery will be reviewed and completed.
To identify any risks associated with receiving a general anesthetic, the anesthesia staff will conduct another comprehensive assessment. To administer any medications that will be required during surgery, an IV (intravenous) catheter will be inserted.
When you walk into the surgery room, it will be very cold and equipped with a specific surgical bed, monitoring devices, and several other tools required for the procedure. Once the anesthesia team has inserted the endotracheal tube (breathing tube) that is connected to the ventilator for breathing, you will be put to sleep on your back and the surgical team will prepare you for the operation.
To keep the surgical region clean during the procedure, the surgical team will scrub the surgical site's skin with an antiseptic agent and then cover it with sterile drapes.
Bilateral Salpingectomy Procedure
The following are the steps involved in a laparoscopic salpingectomy:
- The surgeon makes a small incision in the abdomen to install the tiny camera and another incision for an instrument to be used during the surgery.
- The fallopian tubes are then burned through the tissue, banded, cut, or snipped.
- The tubes are taken out of the body.
- The surgeon takes out the tools and camera before using tiny sutures to close the tiny incisions.
- To maintain the wounds clean, dry, and intact, small dressings, either sticky bandages or medical-grade skin glue, will be used.
After the Procedure
The post-anesthesia recovery unit is where the patient will spend the next two to four hours recovering after the procedure. There will be discomfort following surgery, as there always is. Depending on how good they feel after the treatment, the majority of patients will be sent home the same day.
Within a week, the majority of people resume their regular activities and schedules. Some possible post-operative symptoms are:
- Shoulder ache.
- Abdomen pain.
- Feeling bloated or gassy.
- Sore throat if the treatment involved inserting a breathing tube.
The dressings should be left on for the duration specified by your doctor. It's crucial to contact your surgeon immediately if the incisions start to bleed or leak pus.
Salpingectomy Side Effects
Salpingectomy side effects are possible, as are potential risks with any treatment. You must tell your doctor right away if you see anything out of the ordinary. Infection, internal bleeding, excessive bleeding at the incision site, harm to neighboring blood vessels, harm to nearby organs, and hernia are a few examples of atypical salpingectomy side effects. It's also possible for the anesthetic to have negative effects.
Following your doctor's instructions is the best approach to prevent unwanted adverse effects. Additionally, it is normal to contact your doctor's office if you suspect an issue. For instance, something is wrong if you experience a fever, nausea, or increasing pain. Additionally, if you are unable to empty your bladder or experience any discharge, irritation, or swelling at the surgical site.
Bilateral Salpingectomy Alternatives
Even while some individuals with Fallopian tube disorders require intensive care, they may still want to become pregnant naturally. Some medical professionals might advise fallopian tube reconstruction as an alternative to fallopian tube removal.
- Salpingostomy. A salpingostomy entails clearing a blockage from the Fallopian tube or making a new opening, sometimes referred to as a stoma. When a patient's tubes have been harmed by illness, prior surgery, or adhesions, it is frequently employed. Organs stick together because of adhesions, which are patches of scar tissue.
- Fimbrioplasty. The majority of salpingostomies are performed along with a reconstruction surgery called a fimbrioplasty to save the tiny, delicate fimbriae. A mature egg is directed toward the fallopian tube's opening by the fringe-like fimbriae. When the fimbriae are preserved, women who want to get pregnant naturally have higher fertility.
Salpingectomy surgery can remove malignant tissue in addition to sterilizing the patient. Despite being less invasive, the technique does pose some risks. Tubal sterilization does not offer protection from sexually transmitted diseases (STDs). To avoid sterilization regret, women having this operation should carefully evaluate the effects of permanent sterilization.