Laparoscopic sterilisation
Information for patients from Women's Health
You have been given this leaflet as you are considering having a laparoscopic sterilisation. This leaflet explains:
what laparoscopic sterilisation is.
how it could help you.
what the risks are.
what will happen before and after your surgery.
If after reading this leaflet you have any questions, please speak to your doctor.
What is laparoscopic sterilisation?
Laparoscopic sterilisation is a minor surgical procedure performed under a general anaesthetic. It provides permanent contraception by blocking the fallopian tubes, usually with metal clips. This prevents the egg from the ovaries travelling to the womb (uterus), and prevents the egg and sperm from meeting. This means there will be no fertilisation or resulting pregnancy.
What happens during a laparoscopic sterilisation?
A laparoscope is a small flexible tube (telescope) which contains a fibreoptic light and camera. The camera shows images of the inside of the abdomen or pelvis on a screen.
Your surgeon will make small incisions (cuts) near your belly button. Cuts may also be made on either side of the lower part of your abdomen (tummy). These cuts allow your surgeon to insert the laparoscope. Carbon dioxide gas is then pumped into your abdomen, which expands allowing your surgeon to see your pelvic organs clearly.
One or two clips are then added to each of your fallopian tubes, to occlude (close-up) both tubes. Sometimes a ring is used instead of a clip.
Occasionally, a clip can come free of the fallopian tube. This does not mean that the sterilisation has failed, as there will still be a gap in the fallopian tube where the clip was.
What are the benefits?
Laparoscopic sterilisation is a permanent form of contraception.
Are there alternatives?
There are alternative methods of contraception. These will be discussed with you during your outpatient appointment. Some of these methods work well and have the advantage of being reversible.
There are important points to think about before you agree to sterilisation.
The first is that sterilisation has to be regarded as irreversible. The NHS does not try to reverse sterilisation. It is very important that you are absolutely sure of your decision before choosing this procedure.
Like other methods of contraception, sterilisation can fail. In around one in 200 cases the fallopian tube will re-join. If this happens, you will be at higher risk of having an ectopic pregnancy, which can be a serious condition. An ectopic pregnancy is a pregnancy outside the womb. Therefore, if you ever miss a period following sterilisation, you should complete a urine pregnancy test immediately. If the result is positive, contact your GP. They may arrange for you to have an ultrasound.
Vasectomy is male sterilisation. It is safer and carries a lower failure rate of one in 2,000.
The Mirena contraceptive coil carries a failure rate of one in 1000 and is a simple and easy treatment. For more information, please read the Trust's Mirena Coil leaflet.
If you have any questions about the points raised in this section, please speak to your doctor.
Is this treatment safe?
All surgery has complications / risks.
Serious complications that can happen during surgery
Failure to get the telescope into your abdominal cavity (one in 50 laparoscopies). We will stop your procedure if this happens.
Not able to add the clips to your fallopian tubes. This could be because our view is hidden by adhesions. We will stop your procedure if this happens.
A hole (perforation) is accidentally made through the wall of the womb during surgery (one in 100 laparoscopies). This usually heals itself, but you may need to stay in hospital overnight for observation.
If damage is done to your bowel, bladder, or blood vessels (one in 1000 laparoscopies) you will need major repair surgery. This is done through a large abdominal incision (laparotomy) and often a blood transfusion. You will need treatment in hospital for several days afterwards.
One woman in 10,000 having a laparoscopy dies as a result of complications.
The chance of a complication increases for women who:
are overweight
have had previous surgery, and
have pre-existing medical conditions.
Risks following sterilisation
The procedure has a one in 200 lifetime risk of failing, for example you will become pregnant.
If you do get pregnant, it is more likely that you will have an ectopic pregnancy (a pregnancy in the fallopian tube). This can be a life-threatening complication. For more information on ectopic pregnancy, see Are there alternatives? above.
In itself, the procedure is unlikely to change your periods. However, your periods may change if you stop other forms of contraception, such as the pill.
In very rare cases, women can be allergic to the clips. If you suffer long-term pain following your procedure, this may be considered as a cause.
The procedure has to be regarded as irreversible. The NHS does not try to reverse sterilisation.
What should I do before I come into hospital?
Please refer to your appointment letter for instructions.
You will be asked to come to a Pre-assessment Clinic. You may have blood tests before your surgery. Refer to your appointment letter for fasting times before your operation. Fasting is when you stop eating and drinking before your surgery.
What will happen when I arrive at the hospital?
On admission you will be greeted by a member of the ward team. They will discuss with you the care you will receive whilst you are in hospital. They will ask you to remove make-up, nail varnish, and jewellery. You will also see your consultant or one of their team. Please use this time to ask any questions, before you sign a consent form.
Why do I need to sign a consent form?
All patients must give permission before they receive any type of medical treatment, test, or examination. Consent is usually given when you sign the consent form before your treatment, but we may ask you to give it verbally.
You must give your consent voluntarily.
The hospital must give you all the information you need to make a decision about your treatment. This is so you can give us informed consent. If you have not been given this information, or you have but you still have questions, please speak to a member of staff.
You must be capable of giving consent. This means that you understand the information given to you and can make an informed decision.
When we ask you to give consent, please use this time to ask any questions you may still have. For more information, please go to the NHS Consent for Treatment web page. Remember, you can withdraw your consent for treatment at any time.
How can I prepare for my surgery?
While you wait for your surgery date, you can start preparing for your operation. Research shows that fitter patients, who are able to improve their health and activity levels before surgery, recover more quickly. Taking an active role in planning and preparing for your operation will help you:
feel in control
leave hospital sooner, and
get back to normal more quickly.
To help with this, you may be contacted by a member of the One You Kent (OYK) team. OYK work in the community, and help patients improve their general health. This includes help and advice on:
Stopping smoking
Losing weight
Getting more exercise
More information can be found on the following web sites.
One You Kent (Kent Community Health)
Fitter Better Sooner Toolkit (Royal College of Anaesthetists)
Will I have an anaesthetic?
You will have a general anaesthetic for this operation (you will be asleep during the procedure).
How will I feel afterwards?
You can expect to have two small cuts in your abdomen (tummy):
one in your navel (belly button) region, and
the other above your pubic hair.
Your surgeon will also make a small cut, usually in your right lower abdomen.
You may feel some pain in your abdomen and shoulders. A nurse will give you pain relief after your operation. Pain relief can be given in different ways, including:
tablets
an injection, or
sometimes as a suppository, which can be given via your rectum (back passage).
You may also develop a urine infection and / or a sore throat.
Some patients feel emotional or ‘weepy’ for the first few days following their surgery. This is normal.
Sterilisation after 30 years of age does not make your periods heavier or irregular.
How long will I be in hospital?
This will depend on the reasons for your operation, or your social circumstances. Many patients who have a laparoscopic sterilisation go home the same day. Although some patients do need an overnight stay in hospital.
Will I have a follow-up appointment?
Follow-up appointments are usually with your GP. You will only come back to the hospital if your GP thinks it is necessary.
What should I do when I get home?
You may feel tired. Try to rest for the first 24 hours.
Do not do any strenuous activities.
For at least 24 hours, do not operate machinery or do anything needing fine coordination or judgement. This includes using a cooker.
Do not make important decisions or sign important documents.
You must not drive a car, or ride a motorbike or bicycle for 48 hours.
Do not drink alcohol or take sleeping tablets for at least 24 hours.
You can eat or drink as you wish, but your appetite may be poor to begin with.
Continue with your normal method of contraception (such as the pill) until your next period starts.
When can I return to work?
This will depend on what job you do. Usually you can return to work within three to five days following your operation. If you are unsure, please speak to your GP.
What do I do if I feel unwell at home?
If you feel unwell at home or have any concerns, please call one of the following.
Canterbury Day Surgery Centre, Kent and Canterbury Hospital, Canterbury
Telephone: 01227 783114 (7:30am to 8pm)
Telephone: 07887 687645 (8pm to 7:30am)Day Surgery, Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
Telephone: 01843 234499 (7:30am to 8pm)
Telephone: 07887 651162 (8pm to 7:30am)Channel Day Surgery, William Harvey Hospital, Ashford
Telephone: 01233 616263 (24 hours a day, 7 days a week)