Tubal ligations were a big deal in the past but this has changed drastically in the last 7 years in my practice thanks to a procedure that has been around for at least 5 years prior to that.
The Essure procedure is a prime example of the recent trend towards minimally invasive procedures.
This is an in-office procedure done with a local anesthetic and involves minimal down time..
What's even better is that you undergo another simple minimally invasive test to confirm that it succeeded before you abandon your current birth control
We’ve been very happy with the modern methods we use in our office for more and more procedures that used to require going to the hospital and having major surgery with general anesthesia. It’s amazing that we do procedures every day that did not exist a few years ago. Our practice is much better as a result. One of the greatest improvements has been in permanent birth control, or what we used to call “having a tubal.” The previous procedure used to cause pain as we inserted a scope through the patient’s navel, and there was some risk involved with hitting a blood vessel or a hidden abdominal structure. Then there would be cauterizing the patient’s tubes, with the risk that the cautery could be too much or too little, which could result in an injury or a pregnancy, respectively. While a permanent birth control method is not for those who are still planning to have children, there are many people who are definitely not planning to ever become pregnant in the future and don’t want to have to depend on birth control pills or other methods that require a lot of effort or cost.
Today we are pleased to offer and
perform the Essure in-office procedure which accomplishes the same
objective in a better, safer, quicker, and less painful way. The Essure
is a tiny insert made of a flexible nickel-titanium polyester alloy
that we place inside the uterus where the tubes are attached to it.
This area is very narrow, only about 1-2 millimeters in diameter (see
the picture). To accomplish this we give the patient 4 kinds of oral
pain medication (which we call a cocktail) that is taken before coming
into the office. We then give additional pain medication as a shot and
also we give local anesthesia for the cervix. A tiny instrument which
is the insertion device is gently placed through the cervix. So there
is no cutting, no scar, and hardly any pain or bleeding. This gives us a
view from within the uterus, and we look up to see the tiny openings at
the top where the tubes meet the uterus. We place the tiny device in
first one side, and then the other. The procedure is done. It usually
takes about 15 minutes total time for both sides to be completed and
does not hurt more than having a period.The opening of the right tube seen as it enters the uterus.
During the next 3 months each tube where the device has been inserted becomes blocked. We confirm this by doing a tubal dye test, and we get a report that shows a successful placement and successful blockage of both tubes. Not only is the procedure easy to do, but the results confirm it has worked before we advise patients to stop using birth control. The end result is a very convenient, safe, and effective method of having a permanent birth control with no cutting, no scar, and very little cost. As it is done in the office, there are no hospital charges for the person or for the insurance company.
We have been performing the
procedure in our office for several years now, and the results have been
great. If you are done having children, you should definitely consider
having a permanent method that is so safe, easy and effective as this.
