A bilateral salpingectomy, often called a bisalp, is a surgical procedure that involves the complete removal of both fallopian tubes. This operation primarily serves as a permanent method of birth control, offering a highly effective way to prevent future pregnancies. Beyond its contraceptive purpose, a bisalp also provides a health benefit by reducing the risk of certain types of ovarian cancer.
Understanding a Bilateral Salpingectomy
The fallopian tubes transport eggs from the ovaries to the uterus, where fertilization typically occurs. A bisalp involves removing both tubes, making natural pregnancy impossible as sperm cannot reach the egg, nor can the egg travel to the uterus.
This procedure differs from a traditional tubal ligation, commonly known as “tying the tubes.” Tubal ligation involves blocking, cutting, or sealing the fallopian tubes, rather than removing them completely. A bisalp is increasingly preferred over tubal ligation for permanent contraception due to its higher effectiveness in preventing pregnancy and its additional protective effect against ovarian cancer. The fallopian tubes do not produce hormones, so their removal does not affect a person’s hormone levels, menstrual cycles, or the onset of menopause.
The Surgical Steps
A bisalp is typically an outpatient procedure performed under general anesthesia. The most common surgical approach is laparoscopy, a minimally invasive technique.
During a laparoscopic bisalp, the surgeon makes a few small incisions in the lower abdomen. A laparoscope, a thin tube with a camera, is inserted through one incision. Additional small incisions are made to insert specialized surgical tools, which are then used to carefully detach and remove both fallopian tubes. This minimally invasive method leads to a quicker recovery compared to open abdominal surgery.
What to Expect During Recovery
Recovery from a laparoscopic bilateral salpingectomy is generally quick. Most individuals can resume light activities within a few days and return to their normal routines within one to two weeks. Pain and discomfort are common immediately after the procedure, particularly at the incision sites.
Some individuals may experience bloating or shoulder pain from residual gas used during the laparoscopic procedure. This discomfort usually resolves within 24 to 72 hours. Following post-operative instructions is important, including avoiding heavy lifting and strenuous activities for one to two weeks. Your healthcare provider will advise on resuming bathing and sexual activity.
Important Considerations
A bisalp offers a permanent and irreversible birth control solution. It has a very high effectiveness rate in preventing pregnancy, with a near 0% failure rate for natural conception. Therefore, individuals should be certain about not desiring future pregnancies before undergoing this surgery.
A significant advantage of bisalp is its role in reducing the risk of certain types of ovarian cancer. Research suggests that many high-grade serous ovarian cancers originate in the fallopian tubes rather than the ovaries themselves. Removing the fallopian tubes can reduce ovarian cancer risk by an estimated 42-77% compared to traditional tubal ligation. However, a bisalp does not protect against sexually transmitted infections (STIs), and other protective measures remain necessary. This procedure is suitable for individuals certain about permanent contraception and interested in the added benefit of ovarian cancer risk reduction.