Implementation of opportunistic salpingectomy during cesarean delivery: Temporal adoption and surgeon‐related determinants

OBJECTIVE: To evaluate the implementation of opportunistic salpingectomy for permanent contraception during cesarean delivery, assessing temporal adoption, the association between specialist training and adoption, and surgical feasibility. METHODS: A retrospective observational cohort study was conducted on all consecutive patients requesting permanent contraception during cesarean delivery between January 2010 and December 2025. Temporal adoption of bilateral salpingectomy was evaluated using logistic regression and structural change analysis. The correlation between each surgeon's residency completion year and proportion of bilateral salpingectomies performed was assessed using Spearman's rank correlation. RESULTS: Among 12 648 cesarean deliveries, 801 patients requested permanent contraception. The procedure was completed in 777 (97.0%) cases. Bilateral salpingectomy progressively replaced tubal ligation during the study period, accounting for 90.9% of sterilization procedures in 2025 (odds ratio per calendar year 1.35, 95% confidence interval 1.28-1.42; P < 0.001). No temporal breakpoint in adoption was identified. Adoption varied among surgeons and was associated with the year of completion of residency training (Spearman's ρ = 0.77; P < 0.001). CONCLUSION: Opportunistic salpingectomy was progressively implemented as the preferred technique for permanent contraception during cesarean delivery without compromising the feasibility of the procedure. Adoption occurred gradually over time and was strongly associated with the period of specialist training, suggesting that differences in training context may influence the implementation of ovarian cancer prevention strategies.