Permanent Methods

Mini-Laparotomy for Tubal Ligation

April 13, 2018

A mini-laparotomy (also referred to as a mini-lap) is one of the three most common methods of tubal ligation. These elective forms of surgical contraception are usually referred to as”having your tubes tied.” Another methods comprise laparotomy and laparoscopy.

The mini-lap is a less invasive form of a laparotomy. It involves a smaller incision and can be performed in the time of or just after childbirth.

A laparotomy, by contrast, is performed at any time and requires a much larger incision because the fallopian tubes are less accessible. 

The third option, laparoscopy, is a complicated surgical procedure in which a fiber-optic apparatus is inserted through the abdominal wall through a keyhole incision. It is a minimally invasive procedure that could frequently be carried out on an outpatient basis.

Comparing Mini-Laparotomy and Laparoscopy

The mini-lap is a frequent procedure that is known to be safe and successful in preventing future pregnancies by stopping a woman’s eggs from hitting her fallopian tubes where fertilization takes place.

It presents several advantages over laparoscopy since it requires less sophisticated equipment, less ability to perform, and can be performed in the hospital immediately after delivery or prior to being discharged. Most often, it’s performed within 48 hours of childbirth.

Complications from a mini-lap are marginally higher than those for a laparoscopy, but, in both situations, they are rather rare. If they do happen, they are normally connected to the pregnancy itself rather than the process.

How the Mini-Laparotomy Is Performed

Many surgeons prefer to do a tubal ligation soon after childbirth.

This is because you are already at the hospital, and your abdominal wall is relaxed. Additionally, pregnancy pushes the top of your uterus close to the belly button in which the incision would be made. This allows for easier access to the fallopian tubes.

To get a mini-laparotomy, you will be granted either a general or regional anesthesia (most commonly a epidural). The surgery would subsequently be performed from the next measures:

  • The surgeon will make a small but observable incision right beneath the umbilicus.
  • The fallopian tubes will then be pulled out and out of the incision.
  • The tubes will then be put into place and the incision closed with stitches.

Most women recover in a day or two or longer if the incision is large. Complications are uncommon but may include infection (both inner and at the incision site) and separation of these tied tubes.

Risk of Pregnancy Following a Mini-Laparotomy

The probability of getting pregnant after a tubal ligation is currently 1.2/1,000 from the very first one to two decades and 7.5/1,000 more than seven to 12 years, therefore it is considered an extremely effective way of birth control. While the odds are low, a woman may become pregnant following a mini-laparotomy when the following occurs:

  • The surgery fails to close the passageway in both or one of the fallopian tubes.
  • The fallopian tubes grow back together again.
  • Recanalization occurs, leading to the formation of a new passage that allows the sperm and egg to match.
  • The woman was already pregnant once the surgery was completed.

Becoming pregnant after a mini-laparotomy conveys an increased risk of an ectopic pregnancy, a condition wherein the embryo develops outside the uterus (most commonly in a fallopian tube).

Ectopic pregnancy is a significant medical condition and, if left untreated, can result in the rupture of the fallopian tube, internal bleeding, shock, and sometimes even death. Symptoms include the stoppage of menstrual periods, vaginal bleeding, lightheadedness, shoulder pain, and severe abdominal or pelvic pain.

Symptomatic ectopic pregnancy is regarded as a medical emergency in need of immediate care.