Tubal Ligation – Pomeroy Technique
Pomeroy Tubal Ligation and Resection
Tubal ligation and resection (removal) of a portion of the fallopian tube is the most frequent method of blocking the tubes. This involves tying a segment of tube and removing it. There are many variations of this technique. The tubal ligation procedure described by Dr. Ralph Pomeroy a century ago is most commonly used today.
With the Pomeroy method of tubal ligation, part of the tube is elevated to create a loop or knuckle (top picture). An absorbable ligature is tied around the base of the elevated segment, and the tubal segment is cut out (middle picture).
Within a few days, the peritoneum (tissue that lines the organs of the abdominal cavity) grows over and covers the cut ends of the tubal segments. The cut ends of the fallopian tube separate as the ligature dissolves. The peritoneal covering and separation of the remaining tubal segments prevent them from re-attaching to each other (bottom picture).
Doctors like the Pomeroy procedure because it is simple and effective. Pomeroy tubal ligation is most often performed after delivery by cesarean section.
Pomeroy tubal ligation typically leaves two healthy segments of fallopian tube that can be rejoined through tubal ligation reversal surgery. The amount of tube removed can be determined prior to tubal reversal from the tubal ligation operative report and pathology report. If you have your doctor or hospital send us these reports, Dr. Monteith will review them and let you know what your prognosis for pregnancy will be after tubal reversal.
Variations of the Pomeroy tubal ligation technique include the length and location of the tied and cut tubal segment, number and type of ligatures placed around the tube, and whether the cut ends of the tube were also crushed or coagulated. These variations of the Pomeroy procedure determine the lengths of tubal segments remaining that can be repaired. The Pomeroy method of tubal ligation is a good one to have if you are considering tubal reversal surgery. Approximately two-thirds of women with a Pomeroy tubal ligation become pregnant following tubal ligation reversal.
Tubal ligation procedures
Normal fallopian tube anatomy and other tubal ligation procedures described in the following pages are:
- Pomeroy Tubal Ligation
- Tubal Rings and Clips
- Monopolar and Bipolar Tubal Coagulation
- Parkland and Irving Procedures
- Essure and Adiana (Hysteroscopic Procedures)