Types of Tubal Ligation
Pomeroy Tubal Ligation is usually performed following delivery in the postpartum period. It is usually performed via a small, subumbilical incision. A knuckle of the tube is grasped with an instrument and a suture is tied around the knuckle. The knuckle is then resected and this portion is sent to pathology. Reversal of Pomeroy Tubal Ligation is very successful.
Fallope Ring Ligation is performed via surgery known as laparoscopy. A rubber silastic band is applied across a small knuckle of tube to occlude the tube. There is no resection of tube and no pathology report. Reversal of Fallope Ring Ligation is very successful.
Hulka or Filshie Clip Ligation is performed via laparoscopy. A plastic clip is applied across the tube. Hulka or Filshie clips result in minimal damage to the tubes. There is no resection of the tube and no pathology report. Reversal of Hulka or Filshie Clip Ligation is very successful.
Bipolar & Monopolar Cautery Ligation is performed via laparoscopy. An instrument is applied across the tube and the tube is cauterized or burned. A moderate to large amount of the tube may be damaged. There is no resection of the tubes and no pathology report. If the tube is cauterized in only one location, successful repair is possible. If the tube is cauterized in multiple locations, the likelihood of a successful reversal is very low.
Fimbriectomy is performed via laparoscopy or through an abdominal incision. The distal end (fimbria) is removed. This portion of the tube is sent to pathology and a pathology report should be available. New fimbria can be created at the time of tubal reversal surgery (neosalpingostomy); however, the pregnancy rates are low.