Tubal ligation is a permanent method of birth control. General anesthesia is used and a telescope (laparoscope) is placed through an incision in the belly button as an outpatient procedure (except for those cases done at the time of c-section or in the immediate postpartum period). The fallopian tubes are visualized and ligated either by cautery (burning the tubes) or fallope rings (plastic rings that are used to block the tubes) or clips.
Tubal ligation should be considered permanent (not reversible), and patients should be positive they will never want more children before embarking on this procedure.
No method is without a failure rate, including tubal ligation, and patients should be counseled that the risk of pregnancy with tubal ligation ranges from 1/300 to 1/1000. Pregnancies that do occur after tubal ligation have a high chance of being in the fallopian tube (ectopic) and can be life threatening. An unexpected missed menses in a patient with a prior tubal ligation should prompt a pregnancy test.
Risks of the procedure include anesthesia, bleeding, infection, laparotomy and injury to other organs.