Don't want any more children – but can't face major surgery The 20-minute op that lets you ditch the Pill for good
00:37 GMT, 24 April 2012
The idea of surgery under a general anaesthetic can put some women off sterilisation. Lucy Barrett, 44, a mother of two from Braintree, Essex, was one of the first British patients to have a new minimally invasive operation, as she tells Carol Davis.
Worry-free: Lucy Barrett's family is complete
After my son Lance was born 27 years ago, I started taking the Pill because I didn’t want another child. I was very young at the time — just 17 — and was struggling to make ends meet.
However, around 14 years ago I found I was pregnant again, but scans revealed it was ectopic — the embryo was growing on the outside of my womb — and I had to have surgery.
I went to talk to my GP about sterilisation as I simply couldn’t bear the thought of having another unwanted pregnancy.
He referred me to St John’s Hospital in Chelmsford, Essex, where doctors explained that they could operate under general anaesthetic, making two small incisions in my abdomen through which they would put a clip on the fallopian tubes.
They explained that these carry the egg from the ovary to the womb and is often the area where an egg is fertilised. Blocking them would prevent the sperm reaching the egg.
But on the day of the operation, I had a bad cold and the anaesthetist said they’d have to postpone it until I was well.
In the meantime, I started to have second thoughts about taking such a drastic step.
I was glad I didn’t, because my son Ross was born nine years ago when I was 35.
However, this was definitely the end of my child-bearing years — I felt I’d had two lovely boys and that was it.
I stopped taking the Pill because it made me put on weight and swapped to the contraceptive coil, but this gave me horrible stomach cramps every day, so I had it removed after a month.
I needed to find a means of birth control that would work for me and again sterilisation seemed to be the ideal option, so three years ago I went back to my GP, who referred me again to St John’s Hospital.
Second thoughts: Lucy Barrett had been booked in for surgery to make a small incision and cut the fallopian tubes, but had to miss the operation when she was ill on the day. (Picture posed by model)
I decided to go ahead with the operation this time, though I knew that as a busy mum with a very active six-year-old, I would find it difficult to take a break from swimming and playing with Ross while I recovered from an operation, which can take around seven days.
However, after around three months on the waiting list, the consultant gynaecologist, Phil Robarts, called me to say he was about to start using a new procedure.
Instead of having to operate, he could block my fallopian tubes with two tiny implants, each the size of a grain of rice. Best of all, there wouldn’t be an incision, because he would insert a type of tube into the womb through the vagina, and then use energy waves to make a tiny area of damage on the fallopian tubes.
Then he would place the implant over the damaged area. As my body healed, tissue would grow into the implant and block the tube. He would then do the same on the other side.
The whole thing would take only 20 minutes, and because there wouldn’t be any incisions or scars, and no general anaesthetic, there was less risk of infection and a much shorter recovery time.
This meant I could go straight home and look after Ross.
I felt wonderful afterwards — there was no bruising or pain, so I didn’t even need painkillers.
I’m a busy mother and I also love looking after my two- year-old grand-daughter Lily — but best of all, now that my family is complete, I no longer have to worry about having an unwanted pregnancy.
Phil Robarts is a consultant gynaecologist at Springfield Hospital in Chelmsford, Essex, and previously worked at St John’s, Chelmsford, before its recent closure. He says:
When women are 100 per cent certain their family is complete and they no longer want to use the Pill or other contraceptives, many consider sterilisation. Indeed, 16,000 women a year opt for this.
Female sterilisation is performed by keyhole surgery, which involves making a 5mm to 10mm incision under the tummy button and inserting a laparoscope so we can see the fallopian tubes, which carry the egg from the ovaries to the womb.
Longer recovery: Conventional method of sterilisation involve general anaesthetic. (Posed by models)
Another incision is made lower on the abdomen and a tiny tube is inserted, which places a type of clip on the fallopian tube and blocks sperm from reaching the egg. However, this method involves a general anaesthetic and abdominal operation.
It also means women need five to seven days to recover.
But a procedure was invented four years ago by Australian gynaecologist Professor Thierry Vancaillie and introduced to Britain in 2009.
Instead of making incisions, we can access the fallopian tubes through the vagina, so the patient does not need a general anaesthetic.
The Adiana procedure involves placing a tiny silicon plug the size of a grain of rice at the opening of each fallopian tube as it leaves the womb.
A superficial burn to the lining of the tubes causes scar tissue to form. This grows through the silicon sponge, so the combination of the scar tissue and the plug act to block the tube.
After 12 weeks the tube is blocked. This procedure has a success rate of 98.7 per cent — close to the success rate of the conventional sterilisation procedure (99.5 per cent). The procedure takes just a few minutes and the patient is given local anaesthetic or pain relief.
First, a fine telescope (hysteroscope) is passed through the vagina and into the womb, so we can see the openings of the fallopian tubes.
A catheter (a tiny tube) is then inserted via the hysteroscope. Its tip, which delivers high- frequency energy waves, is placed about 1cm into the fallopian tube.
The energy waves are used to burn the lining, and the silicon plug is released into the fallopian tube. The process is repeated on the other tube. The patient is usually able to go home within an hour or two.
It is important that the patient continues to use contraception for three months until an X-ray confirms that the tubes are blocked and the procedure has been successful.
The Adiana procedure is being performed at several centres throughout Britain.
It is popular because it offers a safer and simpler form of permanent contraception.
The procedure costs 1,500 privately and a similar cost to the NHS.