Pearl obstetrics | gynaecology

How straightforward is a sterilisation procedure?


What are the types of laparoscopic sterilisation?

There are two main ways of performing sterilisation at laparoscopy (a type of keyhole surgery).

The first, more common, method is to place specially designed clips on the tubes. These clips crush the tubes causing a small portion to be blocked. The clips remain in the body. Sometimes they migrate but this rarely causes problems. Sometimes the clips may be thought to cause pain afterwards – the so-called sterilisation syndrome. An attempt at reversal may be used with this type of sterilisation, but reversal is unreliable.

The second method is to remove both Fallopian tubes completely using special instruments. This is a more involved procedure, more costly, but has the advantage of leaving no foreign body behind. This sterilisation can not be reversed, which may or may be an advantage.

What happens at surgery?

A general anaesthetic is used. A camera is placed through an incision in your tummy button. With the clip method, another 1cm incision is made above the pubic bone, an instrument is passed through and the Fallopian tubes are clipped. Any pelvic abnormalities found may be treated at the same time eg. endometriosis and adhesions. The operation usually takes less than an hour. If you wish the second more complex operation ie. removal of the tubes, this requires 2 smaller incisions on each side instead of the 1cm middle one. This operation takes longer.

Important points

It’s an “irreversible” procedure

This operation should be regarded as permanent. Most women who change their minds end up having to have IVF. Reversal is only occasionally successful when clips are used and very expensive.

Failure rate

Women occasionally get pregnant after this operation. The pregnancy rate after clips is reported to be 1 | 200-500 depending upon age – the tubes rejoin together and become open again. Even if you have the tubes completely removed, pregnancy can still occasionally occur! If you did become pregnant, the pregnancy might be ectopic, so you would need to see a doctor if you were pregnant.

Laparoscopy risks

Generally very safe surgery. Serious bleeding or damage to the bowel or bladder are the most important complications, which is said to occur in 1 | 500 cases. Special techniques are used to minimise these risks. Minor infections or bruises are common and settle with time and | or antibiotics.

Any surgical or invasive procedure carries risks. Before proceeding, you should do your own research. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For instance, your GP’s opinion will be very helpful.

After the operation

Normally a day-case operation. You’ll come in having had no food or drink for 6 hours. Afterwards you’ll probably feel drowsy and perhaps slightly sick, which will wear off quickly. You’ll need someone to take you home and be with you overnight.

Will it be painful?

It’s usually not too bad. There may be some pain or discomfort for usually up to a week, but you’ll have pain relief. Sometimes the pain is in your shoulders – this is normal and will settle. Rest up for a few days and have the rest of the week off work.


Keep them clean and uncovered. Bathe & dry thoroughly but gently. If they become red, get some antibiotics – the earlier the better. It may be a minor infection (that 1 | 20 women get despite us giving antibiotics during the surgery). The stitches will dissolve and come away themselves.

When can I drive?

Usually after a few days when you feel ready and the pain has settled.

When can I go back to work?

Have the rest of the week off. Ask us for a sickness certificate if needed.

When can I have sex?

When you feel ready. Continue your usual contraception until your next period (unless you’re on your period at the time of the operation).

Dr. Mark Sillender. Consultant obstetrician & gynaecologist