Colpotomy is a type of vaginal sterilization procedure (the other type is culdoscopy). A colpotomy, also known as vaginotomy, is considered to be minimally invasive surgery. The vaginal method of tubal ligation was once the preferred technique. However, since it is associated with higher risks than laparoscopic surgery, surgeons have been favoring the abdominal approach to transvaginal procedures.
A major advantage of a colpotomy is that there are no abdominal incisions. Colpotomy tends to be reserved for obese patients or for women with a retroverted uterus. This transvaginal procedure involves a small incision made into vaginal wall. Research is showing that this method is safer than originally thought. Yet, a culpotomy may be difficult to perform because it requires a woman to be in a knee-to-chest position while under local anesthesia.
During a colpotomy, an incision is also made into the posterior vaginal fornix (the back of the vagina). The surgeon then inserts a intrauterine sound through the incision into the peritoneal cavity (the space within the abdomen that contains the intestines, the stomach and the liver). The intrauterine sound -- an instrument designed to help probe and dilate passages within the body -- helps the surgeon to manipulate the uterus and bring the fallopian tubes to view. The tubes are brought out through the incision, into the vagina, where they are closed off (tied, clipped, or sealed shut), and put back into place. The incision is stitched shut.
A colpotomy takes about 15 to 30 minutes, and women are able to go home the same day.
It may take a few days at home to recover. Sexual intercourse is usually postponed until the incision is completely healed, which usually requires several weeks, and there are no visible scars.