Bilateral Salpingectomy
What is a Bilateral Salpingectomy?
A bilateral salpingectomy is the surgical removal of both fallopian tubes. The tubes connect the ovaries to the uterus in the female reproductive system and their function is to transport the egg from the ovaries to the uterus. They don’t produce any hormones so their removal doesn’t cause any hormonal changes including menopause. This procedure is generally performed for gynaecological or obstetrical reasons, including the treatment of ectopic pregnancy, part of the surgical treatment of gynaecological cancer, or for the reduction of the risk of ovarian cancer in genetically predisposed.
In recent years, bilateral salpingectomy has been seen as an alternative to traditional methods of contraception, as the procedure provides permanent birth control with a low risk of complications.
A bilateral salpingectomy is usually performed laparoscopically; a minimally invasive surgical technique that involves the use of small incisions. It's important to note that while a bilateral salpingectomy can prevent pregnancy, it does not provide protection against sexually transmitted infections (STIs).
Women who have undergone this procedure may still need to use other forms of contraception to prevent STIs and to protect their sexual health.
Reasons to get a bilateral salpingectomy
There are many reasons why women may choose to undergo a bilateral salpingectomy, including:
- Permanent contraception: tubal ligation or clipping the tubes is a form of permanent birth control used traditionally that involves blocking or cutting the fallopian tubes. It has a failure rate of approximately 1:200 leading to pregnancy as the tubes can come back together. A salpingectomy can be performed as an alternative to tubal ligation with a much lower failure rate. It also reduces lifetime risk for ovarian cancer and can especially be used for women who are at high risk of ovarian cancer, or who have a family history of ovarian or breast cancer.
- Ectopic pregnancy: An ectopic pregnancy is a pregnancy that occurs outside of the uterus, most commonly in the fallopian tubes. If the pregnancy is not treated, it can be life-threatening. In many cases, a salpingectomy is required to remove the affected fallopian tube.
- Fallopian tube cancer: Cancer of the fallopian tubes is rare, but when it does occur, a salpingectomy may be necessary to remove the affected tissue.
- Infection: If a woman has a severe infection in her fallopian tubes, a salpingectomy may be required to remove the infected tissue and prevent the spread of the infection.
Before undergoing a fallopian tube removal surgery, also known as bilateral salpingectomy, there are a few steps you can take to prepare yourself for the procedure and ensure a smoother recovery.
While your surgeon will provide specific instructions, the following guidelines can help alleviate any anxieties you may have on the day of the operation:
- Arrange transportation: It's important to arrange for someone close to you, such as a family member, loved one, or friend, to drive you home after the surgery. The effects of anaesthesia can leave you feeling unsteady, and you may experience abdominal discomfort. Having a support system in place can provide peace of mind and comfort.
- Wear comfortable clothing: Prepare for your recovery period by wearing loose, comfortable clothing on the day of the surgery. This could include loose sweatpants and a t-shirt, allowing you to rest and recover without any restrictive clothing, especially around the abdominal area.
- Update your medical history: Although your doctor likely reviewed your medical history during your initial women's health examination, it's crucial to inform your surgeon about any changes in prescriptions, supplements, or other relevant medical information leading up to the procedure. Open communication helps avoid complications that could arise due to unforeseen interactions or conditions. Take the opportunity to ask your surgeon any questions you may have as well.
- Fasting and fluid intake: Depending on the surgery's timing and the type of anaesthesia used, you may be required to fast before the procedure. Morning appointments allow you to skip breakfast in such cases. However, it's essential to consult your doctor regarding fasting requirements, including restrictions on drinking water, as emergencies or delays may occur with other patients.
The procedure itself can be performed as either a laparoscopic surgery or an open abdominal operation, and your doctor will recommend the appropriate option based on your specific case, age, and overall health.
An open abdominal salpingectomy is usually a part of a bigger procedure and is done under general anaesthesia. Once under anaesthesia, your surgeon will remove the fallopian tubes through an incision made in your lower abdomen. The incision will then be closed using stitches or staples.
Laparoscopic bilateral salpingectomy, is mostly under general anaesthesia. This minimally invasive approach offers a quicker recovery. During the procedure, your surgeon will make a small incision in your lower abdomen and insert a laparoscope—a device equipped with a light and camera. This camera provides a clear view of your fallopian tubes, allowing the surgeon to make additional small incisions and use specialised tools to remove the tubes.
Following the fallopian tube removal, it's important to understand the recovery process:
Healing timeline: Complete recovery from an open bilateral salpingectomy typically takes up to six weeks. Conversely, the laparoscopic procedure's smaller incisions promote faster healing, and recovery usually takes two to four weeks. These timelines can vary depending on individual cases.- Immediate postoperative period: Your recovery will begin immediately after the procedure when you're brought back to your room for monitoring. It's normal to feel groggy after anaesthesia, and it may take a while for your body to fully awaken. You may experience some discomfort or pain around the incision site. Your release from the medical facility may be contingent upon your ability to stand up and empty your bladder.
- Returning home: Most patients can go home on the same day as the procedure. However, it's crucial to have a familiar person accompany you for a safe trip home. While you can generally resume your routine within a few days, it's important to avoid strenuous activities like exercise or heavy lifting. The recovery period can vary for each individual, so it's crucial to listen to your body's signals and not push yourself beyond your limits.
Remember, your surgeon will provide specific post-operative instructions and guidelines tailored to your individual case. It's important to follow their advice and recommendations closely for a successful recovery. If you have any concerns or questions during your recovery period, don't hesitate to reach out to your healthcare provider for further guidance and support.
It's important to note that a salpingectomy is a permanent procedure that will prevent a person from becoming pregnant through natural means. If fertility is desired in the future, options such as in vitro fertilisation (IVF) or adoption may be considered.
