For patients who desire permanent sterilization and cannot or do not wish to have the Essure procedure performed in the office setting, we offer Laparoscopic Bilateral Tubal Ligation in the outpatient surgery center. This procedure is minimally invasive, but requires general anesthesia. Usually only one 10mm incision is made in the umbilicus and the fallopian tubes are either ligated using bipolar cautery or application of permanent clips. Post-operative pain is usually mild. Most women resume their normal activities within two-three days and recovery is mainly due to recovery from anesthesia effects and returning to normal bowel movements. The effect is immediate and patients do not need a back-up method of birth control.