This page provides basic knowledge about the medical procedures known as
sterilizations.
We prefer the terms tubal ligation or salpingectomy rather than sterilization. If
veterinary surgeons sterilize female animals they usually remove both ovaries. This
is never done in human beings. In humans both Fallopian tubes are clamped, tied or
cut. Any operation leading to infertility is a sterilization,oophorectomies
(removal of the ovaries ) and hysterectomies can therefor also be regarded as sterilizations.
A partial salpingectomy refers the removal of a part of the Fallopian tube ( a part of the
tube is cut out) and a tubal ligation refers to the tying of a tube.
In human males sterilization operations are always referred to as vasectomies
( even when the seed tubes are only tied or clamped). We feel that the term sterilization should be
discarded and be replaced by either the term salpingectomy or the term tuboligation.
A graphic presentation of the different types of tubo ligations available will now follow.
It will also include drawings to illustrate why the operation fails to prevent pregnancy
in about 1 out of ten to twenty thousand cases.
A Graphic Presentation of the Procedures Known as Tubal Ligations and Partial Salpectomies.
Female Sterilizations
CLAMPING THE TUBES
The next drawing show how a Fallopian tube is clamped.
It is done through minimal access surgery via a laparoscope
FIG 1
This drawing shows the applicator and the clamp approaching the Fallopian tube.
The applicator passed through a small incision below or next to the camera's
entrance. The whole procedure is monitored on a television screen.
FIG II
This drawing shows both clamps applied to the Fallopian tubes.
FIG III
This drawing show the appearance of the tubes after a few months. The clams closed
water tight and the clamped part plus the surrounding part of the tubes die. The blood
supply is interrupted by applying the clamps. The with of the destruction is slightly wider
than the width of the clamps.
The following video clip shows a tubal ligation being performed using the clips.
The next drawing illustrate the application of Fallopian Rings. It is also a laparoscopic procedure.
A special applicator is inserted in the abdominal cavity . The applicator contains a special
forceps (tweezers) to grasp and lift the tube as illustrated in the next drawing.
The next drawing shows how the Fallopian tube is pulled into the applicator.
While a part of the tube is pulled into the applicator, the applicator applies the ring around the
tube blocking its lumen. The tube is than released . The next drawing illustrates the tube after
the ring is applied.
The next drawing shows the long term effects on both tubes. The tissue caught in the ring dies
and disappears. (The rings close the tubes water tight and the blood supply to this part of the
tube is stopped).
The following video clip shows a tubal ligation procedure performed using Fallopian Rings.
With this procedure a piece of the tube ( usually 5-10 mm in length) is removed, The correct
medical term is a partial salpingectomy. The next drawing shows how the tube is cut.
The next drawing illustrates how a piece of each Fallopian tube is separated.
Sutures are applied to all the cut edges. These stitches block the tubes and prevent bleeding.
This is illustrated in the next drawing.
The next drawing shows the long term effects of a partial salpingectomy.
A SUMMARY AND GRAPHIC EXPLANATION OF FAILED STERILIZATIONS
Why Is It Possible To Conceive After A Sterilization ?
It doesn't matter which method is used to do a tubal ligation, there is always
swelling of the remaining parts of the tubes. This is illustrated in the next drawing.
The next event rarely happened. The swollen ends reach each other and fuse. This is
illustrated in the next drawing.
It is possible for a new lumen (or canal) to develop in the area where the two segments
fused. This is possible due to the unique healing capabilities of our bodies. If this happens
a pregnancy can result. The change of this happening is between one in ten thousand and one in
twenty thousand. This process is illustrated in the next drawing.
Not all pregnancies following a tubal ligation ( sterilization) are normal. Many are ectopic
pregnancies. There are two possible reasons. The one is that part of the tube that was repaired is
to narrow to allow the fertilized egg to pass and a tubal pregnancy occurs. ( see
ectopic pregnancies . The other possibility is illustrated in the
next drawing. The tubes are separated but a small opening exist in one of the tubes that is
connected to the womb. Sperms pass through this opening , fertilized an egg. The egg than enters
a blocked segment and an ectopic pregnancy occurs.
This is just an attempt to explain in a simple way, why sterilizations fail . It is not intended
to cover all the possibilities or to be a detailed medical description of the process. We hope that
it will
give you some insight in the remarkable recovery potential of our bodies.
