Bilateral tubal ligation procedure steps

The surgical procedure for bilateral tubal ligation typically includes the following steps: preoperative preparation, incision, localization of the fallopian tubes, confirmation of the fallopian tubes, and tubal ligation. The detailed steps are as follows:

Preoperative preparation: The patient should empty the bladder, lie in a supine position with hips elevated, and undergo routine skin disinfection and draping.

Making the incision: Make a 2–3 cm vertical incision 4 cm above the pubic symphysis in the mid-lower abdomen, followed by another vertical incision 2–3 cm below.

Locating the fallopian tubes: The surgeon uses surgical forceps to slide along the posterior aspect of the uterine fundus toward one side until reaching the ovary or fallopian tube, then gently exteriorizes the fallopian tube.

Confirming the fallopian tubes: Clamp the mesosalpinx with forceps, trace to the fimbriated end to confirm the identity of the fallopian tube, and examine the ovary.

Ligating the fallopian tubes: Make an incision in the serosal layer on the posterior aspect of the isthmic portion of the tube, dissect approximately 2 cm of the tubal segment, clamp both ends, and excise 1–1.5 cm of the intervening segment.

Suturing: After ligation, suture the serosal layer closed, embedding one end into the mesosalpinx and the other outside the mesosalpinx.