Patient education: Salpingectomy (The Basics)

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What is salpingectomy? — Salpingectomy is surgery to remove 1 or both of the fallopian tubes. The fallopian tubes connect the ovaries to the uterus (figure 1). About once a month, an egg travels from the ovaries to the uterus through these tubes.

Both fallopian tubes can be removed, or just 1. Or, in some cases, doctors might remove just part of a tube. This is called "partial salpingectomy."

If you have both fallopian tubes removed, you will not be able to get pregnant on your own. If you have 1 fallopian tube, it is usually still possible to get pregnant on your own.

Salpingectomy can be done in 2 ways:

●Open surgery – During an open surgery, the doctor makes a cut, or "incision," in the skin. This allows them to see directly inside the body when they do the surgery.

●Minimally invasive surgery – "Minimally invasive" surgery allows the doctor to make smaller cuts in the skin. They insert long, thin tools through the cuts. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the body. Then, they use the long tools to do the surgery. They can control the tools directly, or with the help of a robot (this is called "robot-assisted" surgery).

You might be able to return to normal activities sooner if you had minimally invasive surgery than if you had an open surgery.

Sometimes, salpingectomy is done at the same time as other procedures. These include:

●Hysterectomy – This is surgery to remove the uterus.

●Oophorectomy – This is surgery to remove the ovaries. When the fallopian tubes are removed at the same time as the ovaries, this is called "salpingo-oophorectomy."

Why might I have a salpingectomy? — You might have a salpingectomy:

●To treat an ectopic pregnancy – This is when a pregnancy is not located in the uterus, where a pregnancy usually is. Ectopic pregnancies often happen in 1 of the fallopian tubes. This can cause the tube to burst open. An ectopic pregnancy is very serious and even life-threatening.

●To treat an infection – An infection called "pelvic inflammatory disease" can cause the fallopian tubes to become blocked or scarred. In serious cases, surgery is needed to remove the tubes.

●As permanent birth control – This means a way to prevent pregnancy permanently. Having both tubes removed means that you cannot get pregnant.

●To treat or prevent certain types of cancer – Sometimes, the fallopian tubes are removed to lower the risk of ovarian cancer. This is because the cancer cells that cause ovarian cancer often start in the fallopian tubes.

●To treat endometriosis – This is when cells like those normally found in the uterus are found outside of the uterus. When these cells are in the fallopian tubes, they can cause pain. Endometriosis can also make it hard to get pregnant.

How do I prepare for salpingectomy? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Imaging tests – Imaging tests create pictures of the inside of the body.

●Lab tests

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●Lowering the risk of infection – In some cases, you might need to trim (not shave) your body hair before your procedure. You might also need to wash the area with a special soap.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during salpingectomy? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include:

•Local – This type of anesthesia uses medicine to numb a small part of your body so you don't feel pain.

•Regional – This type of anesthesia blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●You might get medicines to help control pain after the procedure.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●If you are having open surgery:

•The doctor will make an incision in your belly area.

●If you are having minimally invasive surgery:

•The doctor will make a few small incisions in your belly area.

•Gas will be put into your belly to make it easier to move the laparoscope and tools around.

•The doctor will insert the laparoscope through 1 of the cuts so they can see inside your body.

•The doctor will also insert long, thin tools that they will use to do the surgery. If you are having robot-assisted surgery, the doctor will use a surgical robot to control the tools.

●The doctor will remove 1 or both fallopian tubes, or part of a tube.

●The doctor will close your incisions and cover them with clean bandages.

What happens after salpingectomy? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine to help with pain, if needed. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of salpingectomy? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Bleeding

●Infection

●Damage to nearby organs

What else should I know? — Before you go home from the hospital, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor or nurse's instructions. Ask questions about anything you do not understand.

If you have both of your fallopian tubes removed, you will not be able to get pregnant on your own. If you want to be able to carry a pregnancy after salpingectomy, talk to your doctor. You might be able to have a procedure called "in vitro fertilization" or "IVF." This is when an egg is fertilized in a lab, and then implanted in the uterus. But you probably should discuss this with your doctor before having a salpingectomy.

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Patient education: Salpingectomy (The Basics)