A laparoscopic tubal ligation is an outpatient procedure done under anesthesia to achieve permanent sterilization. The physician places a small (1 cm) incision at the base of the umbilicus and then places a scope thru this incision to view the pelvic structures. The tubes are identified and about one third of the each fallopian tube is destroyed using cautery. This procedure takes about 30 minutes to perform and patients go home the same day. We usually recommend about one week off work after this procedure. The sterilization effect is immediate and no additional testing is recommended to confirm the tubes are blocked. The failure rate is 1 in 250 over a lifetime.