How It Works

Electrocautery, also called electrocoagulation, uses a specialized instrument to pass electrical current through a small segment of the fallopian tube. The heat generated seals (coagulates) the tissue, closing the tube. Surgeons may coagulate a single point or a longer segment, and sometimes divide the tube after coagulating it for added reliability.

Bipolar vs. Monopolar Techniques

Bipolar cautery, which passes current only between two nearby points on the instrument tip, is now standard for tubal procedures because it reduces the risk of current spreading to nearby tissue, compared to older monopolar techniques.

Considerations

Cautery is fast and reliable, with a very low failure rate. Because it can destroy a longer segment of tube than clips or rings, it is generally considered harder to reverse successfully — something worth discussing if there's any chance, however small, that reversal might be desired later, though the procedure should still be approached as permanent.

Safety

Modern bipolar equipment has significantly reduced the historical risk of thermal injury to nearby organs such as the bowel, which was a more notable concern with older monopolar devices. Serious complications remain rare with current techniques and equipment.