Editing Tubal ligation (section)

== Procedure technique ==
Tubal ligation through blocking or removing the tubes may be accomplished through an [[Laparotomy|open abdominal surgery]], a [[Laparoscopy|laparoscopic approach]], or a [[Hysteroscopy|hysteroscopic]] approach.<ref name=":3">{{Cite journal|last1=Bartz|first1=Deborah|last2=Greenberg|first2=James A.|date=2008|title=Sterilization in the United States|journal=Reviews in Obstetrics & Gynecology|volume=1|issue=1|pages=23–32|issn=1941-2797|pmc=2492586|pmid=18701927}}</ref> Depending on the approach chosen, the patient will need to undergo [[Local anesthesia|local]], [[General anaesthesia|general]], or [[Spinal anaesthesia|spinal (regional) anesthesia]]. The procedure may be performed either immediately after the end of a pregnancy, termed a "postpartum" or "postabortion tubal ligation", or more than six weeks after the end of a pregnancy, termed an "interval tubal ligation".<ref name=":02" /> The steps of the sterilization procedure will depend on the type of procedure being used.{{citation needed|date=May 2023}} (See '''Tubal ligation methods''' below.)

If the patient chooses a ''postpartum tubal ligation'', the procedure will further depend on the delivery method. If the patient delivers via [[Caesarean section|Cesarean section]], the surgeon will remove part or all of the fallopian tubes after the infant has been delivered and the uterus has been closed.<ref name=":3" /> Anesthesia for the tubal ligation will be the same as that being used for the Cesarean section itself, usually regional or general anesthesia. If the patient [[Vaginal delivery|delivers vaginally]] and desires a postpartum tubal ligation, the surgeon will remove part or all of the fallopian tubes usually one or two days after the birth, during the same hospitalization.<ref name=":3" />

If the patient chooses an ''interval tubal ligation'', the procedure will typically be performed under general anesthesia in a hospital setting. Most tubal ligations are accomplished laparoscopically, with an incision at the [[Navel|umbilicus]] and zero, one, or two smaller incisions in the lower sides of the abdomen. It is also possible to perform the surgery without a laparoscope, using larger abdominal incisions.<ref name=":3" /> It is also possible to perform an interval tubal ligation hysteroscopically, which may be performed under local anesthesia, moderate sedation, or full general anesthesia.<ref name=":3" /> While no methods of hysteroscopic sterilization are currently on the market in the United States as of 2019, the [[Essure]]<ref name=":0">{{Cite web|url=https://www.fda.gov/medical-devices/implants-and-prosthetics/essure-permanent-birth-control|title=Essure Permanent Birth Control|date=15 May 2019|website=US Food and Drug Administration|access-date=31 July 2019}}</ref> and Adiana systems were previously used for hysteroscopic sterilization, and research trials are investigating new hysteroscopic approaches.