How a Culdoscopy Procedure Works

Concept of gynecology surgery. 3D model of female uterus is near scalpel and medical gloves. Surgery in gynecology and operation on uterus, ovaries or fallopian tubes such hysterectomy or myomectomy
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Culdoscopy is a type of vaginal sterilization procedure (the other type is colpotomy). Also known as transvaginal hydrolaparoscopy, culdoscopy 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 tubal ligation surgery, surgeons have been favoring the abdominal approach to transvaginal procedures.

A major advantage of a culdoscopy is that there are no abdominal incisions. Culdoscopy tends to be reserved for obese patients or for women with a retroverted uterus. This transvaginal procedure involves a small incision made into the vaginal wall. Research is showing that this method is safer than originally thought. Yet, a culdoscopy may be difficult to perform because it requires a woman to be in a knee-to-chest position while under local anesthesia.

The Procedure

During a culdoscopy, an incision is made into the posterior vaginal fornix (the recess behind the cervix). A culdoscope—a type of endoscope with a light, used to visualize female pelvic organs—is inserted through the incision into the peritoneal cavity (the space within the abdomen that contains the intestines, the stomach, and the liver). The culdoscope helps the surgeon to locate the fallopian tubes. The fallopian tubes are pulled through the incision into the vagina. The culdoscope is removed, and the tubes are closed off (tied, clipped, or sealed shut) and put back into place. The incision will then be stitched shut.

A culdoscopy 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.