Definition:

Bilateral tubal ligation (BTL)

Is a surgical procedure that involves blocking the fallopian tubes to prevent the ovum from being
fertilized. It can be done by cutting , burning, or removing sections of the fallopian tubes or by placing
clips on each tubes.

 Laparoscopic tubal ligation

The surgeon makes 3 small incisions, one in or below the belly button and the other two in the lower part
of the abdomen. The surgeon insert a thin, lighted viewing tube called the laparoscope through one of
the incision. The other incision is where the special instrument inserted to cut, tie, or block the fallopian
tubes . The 3rd incision is where the C02 inflated into the abdomen.

 Mini-laparotomy tubal ligation

Involves smaller incision usually 5cm (2in)than a regular laparotomy. The incision made above the
pubic bone. The fallopian tubes are pulled up into or out of incision and then tied off, cut, or blocked and
then put it back into place. This procedure is indicated for woman who have had prior abdominal or pelvic
surgery.

 Open tubal ligation

Is done through a larger incision in the abdomen. It is recommended for woman who need abdominal
surgery for other reasons.

 Cystorraphy

Suture of a wound, injury, it rupture in the urinary bladder.

Purpose:

 Preventing pregnancy
 Decreasing risk of ovarian cancer

Risk factor:

 Bleeding at the sight of incision or internal bleeding in the abdomen.

 Improper wound healing or infections
 Damage to abdominal organs
 Reaction to anesthesia
 Pelvic or abdominal pain
 Failure in the procedure, causing an unwanted pregnancy in the future .
Responsibilities:

Scrub nurse

 Prepare instrument and equipment needed.

 Maintains sterility throughout the procedure.
 Preserves the sterile environment by scrubbing in.
 Selecting and passing the instrument into the surgeon.
 Maintaining patient safety.
 Cleanse the instrument after used.
 Monitor the surgery to make sure everything remains sterile.
 Removes tools and equipment from operating area.
 Helps apply dressing to the surgical site.
 Completes any necessary documentation regarding the surgery or the patients transfer to
recovery.

Circulating nurse

 Responsible for charting what is happening in the operating room.

 Responsible for keeping tracks on the equipment and supplies used.
 Called on to obtain supplies and equipment
 Count the supplies and instrument to make sure nothing was left in the patients surgical site.
 Keeping the operating room clean.
 Preparing patient for the procedure .
 Helping escort the patient into the recovery.
 Act as patient as advocate while patient is under the influence of anesthesia
 Assess the patient condition before, during , and after the procedure .
 Assist the team to create a safe and comfortable environment for the patient.

Anesthesia type and technique:

Type: Regional anethesia

Technique: Sabarachnoid block(SAB)

Anesthetic agents:

 Fentanyl
 Midazolam
 Bupivacaine
  Propofol
 Isoflurane

Prognosis:

How long to fully recovered depends on the type of surgery.

 Laparoscopic – about 1 week

 Mini-laparotomy – about 1-3 weeks
 Open laparotomy – about six weeks

Other conventional surgery:

 Intrauterine device – implanted inside the uterus, releases copper that prevents pregnancy
 Birth control implants such as implanor or nexplanon- implanted in the arm, release progestin
hormone that’s prevents pregnancy
 Hysteroscopic sterilization- where small could is placed in the fallopian tubes, assess tissue growth
and prevent pregnancy
 Vasectomy- getting the man sterilized .

Nursing diagnosis with related factors :

 Acute pain related to post operative surgical incision.

 Impaired skin integrity related to surgical incision secondary to bilateral tubal ligation
 Risk for infection related to tissue destruction.
 A
Written report
On

BILATERAL TUBAL LIGATION/ CYSTORRAPHY

As partial fullfilment of the requirements in O.R OPD

SUBMITTED TO:
BJ R. TOLEDO, RN

SUBMITTED BY:
MARYCRIS. TRAZO
BSN 111A