Tubal ligation, often colloquially called “having the tubes tied,” is a procedure for permanent birth control that physically blocks the fallopian tubes. The purpose of this surgical intervention is to prevent an egg released by the ovary from traveling down the tube to meet sperm, thereby stopping fertilization and subsequent pregnancy. The term “tied” is a simplification, as the visual appearance of the tubes after the procedure varies significantly depending on the specific surgical technique used.
The Anatomy of the Blockage
The ultimate goal is to create a physical barrier or separation in the fallopian tube. A tube in its normal state is a continuous, narrow, muscular canal, which extends from the uterus toward the ovary. After a successful tubal ligation, the tube is interrupted, appearing visually either cinched down, separated into two segments, or physically covered by a device.
The tube remains in the body, but its path is permanently disrupted at a specific point, often the isthmus nearest the uterus. The resulting appearance is a distinct interruption where the continuous passageway once existed. This obstruction prevents the egg and sperm from passing each other, confirming the non-functionality of the reproductive pathway.
How Specific Surgical Methods Affect Appearance
The exact visual result of a “tied” tube is determined by the specific hardware or energy source employed by the surgeon.
Filshie Clips
When Filshie clips are used, the tube appears clamped by a small, hinged device, typically made of titanium and lined with silicone. The clip is placed across a narrow portion of the tube, compressing the tissue and causing it to scar closed, remaining visible as a small metallic structure.
Falope Rings
With Falope rings, the tube has a distinctive “knuckle” or loop appearance where a small, elastic silicone band has been applied. The surgeon draws a loop of the tube into an applicator and releases the ring over the base, constricting the tissue. This cuts off the blood supply to the looped section, causing it to atrophy and separate, leaving scarred tissue cinched by the ring.
Electrocoagulation
A tubal ligation performed using electrocoagulation, or “burning,” leaves a segment of the tube visibly damaged and separated. Bipolar coagulation uses an electric current to cauterize and destroy a section of the tube. This leaves a small gap between the two remaining ends with a visibly charred or blanched appearance at the separated margins.
Pomeroy Method
The classic “cutting and tying” technique, known as the Pomeroy method, creates a different look entirely. A loop of the tube is tied off with an absorbable suture and the segment above the tie is removed. As the suture dissolves, the two cut ends of the tube pull apart and are covered by the abdominal lining, resulting in two short, distinct, separated stumps.
What the External Incision Sites Look Like
The external visual evidence of a tubal ligation procedure is typically minimal, as the surgery is most often performed using a laparoscopic approach. This minimally invasive technique involves making one to three tiny incisions in the abdomen, which are the access points for the camera and surgical instruments. The main incision, usually for the camera, is often placed within the fold of the navel, making it nearly invisible once healed.
Additional incisions, if needed, are very small, often measuring less than one centimeter, and are usually located low on the abdomen, just above the pubic hairline. These small surgical cuts fade considerably over time, often appearing as tiny, light-colored lines or dots on the skin. A less common approach, a mini-laparotomy, involves a slightly larger single incision, typically two to five centimeters long, often used if the procedure is performed immediately following childbirth.