What are side effects after four years of a tubaligation?

None: There generally are no side effects from a tubal ligation done four years prior. However, any surgery of the abdomen can cause adhesions (scarring) that leads to intestinal narrowing or blockage. See your doctor and mention the tubal ligation (or any other abdominal surgery) if you have a change in stool habits, abdominal pain, and/or fever.