Laparoscopic Tubal Reversal

Women who have had a prior tubal ligation can choose to undergo a tubal reversal if they desire to have more children. Tubal reversal surgery is not right for everyone, especially when compared with the risks, benefits, and cost of IVF. However, if a patient prefers this method of fertility restoration, it remains a viable option if performed by a surgeon that is experienced in microsurgical techniques. One way to determine if tubal reversal surgery is a good option for you is to obtain a copy of your operative report from your tubal ligation. This information will allow the physicians at Women’s Health and Surgery Center to determine the type of sterilization that was performed. A copy of your operative report can be obtained from your doctor or from the hospital where your tubal ligation was performed. This can be done by completing our Medical Records Release Form and faxing it to the medical records department of the hospital where your tubal ligation was done.

What is Involved in a tubal reversal?

  • Same-day discharge from hospital to your home
  • Faster recovery
  • Small incisions
  • Less post-operative pain
  • Less risk of wound infection
  • Faster return to daily activities
  • State-of-the-art technology

What is the procedure for a tubal reversal?

Tubal ligation reversal utilizes microsurgical techniques to open and reconnect the fallopian tube segments that remain after a tubal ligation procedure as seen below. Typically there are two remaining segments, the proximal tubal segment that emerges from the uterus, and the distal tubal segment that ends with the fimbria next to the ovary. Tubal ligation reversal (microsurgical tubotubal anastomosis) connects these segments.

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What are the factors that are used in deciding if a tubal ligation reversal makes sense?

The male partner may need a sperm test prior to decision making about tubal reversal vs. IVF after tubal ligation. Other important factors that need to be considered are female age, tubal status (type of tubal ligation), egg quantity and quality and other pelvic conditions that may make the surgical options less successful, i.e multiple surgeries, endometriosis, etc.

What is the procedure to determine if you are a candidate?

Please attempt to have your operative report and pathology report as this provides information as to the type of tubal ligation and amount of tube that may be remaining after the reversal. If you cannot get a copy of your operative report, our physicians may perform a laparoscopy prior to performing the tubal reversal to evaluate if there is adequate tube remaining to complete a tubal reversal. At your initial visit, we will review your prior records as well we may perform a pelvic ultrasound. During this we will discuss with you your options and details of the procedure.

For our patients coming from out of town, you should expect to spend two days in the Stafford/Fredericksburg area. We will schedule your preoperative consultation on the day prior to your surgery and will request that you stay at a nearby hotel the evening following your surgery so that you will be accessible to our medical staff in the event that postoperative care is required. Recovery time from the surgery is generally short and most patients are able to return to work or other normal activities within a week to 10 days.

Does reversing tubes really work?

Tubal reversal surgery at our center can be very successful and can provide patients with an alternative treatment to in-vitro fertilization. Tubal reversal allows you a chance to become pregnant every month and over many months these chances add up and, unlike IVF, tubal reversal allows you the chance to become pregnant more than once. The majority of patients will have patent tubes and become pregnant within one year of their tubal ligation reversal surgery. The pregnancy rate varies by type of tubal ligation, length and health of the remaining tubal segments, a woman’s age and other factors. Furthermore, tubal reversal enables most women to conceive naturally, without having to take fertility medications. Our medical team will consult with you to see if you’re a good candidate for tubal reversal surgery or if you should choose In Vitro Fertilization (IVF).

Questions to ask your doctor?

  • How big will my incision be? Three small incisions that is no bigger than 5 mm.
  • Will you use a robot? Our practice does not feel the robot adds any value to this surgical procedure other than costs. Most advanced laparoscopic surgeons do not feel the robot offer any advantages to their patients.
  • What is the recovery time? Most patients usually recover from tubal reversal in about 10-14 days.
  • How soon will I be able to start trying to conceive? We typically ask that a patient wait about 3 months before starting to try to conceive.

Call our office or schedule an appointment to talk with your doctor about Laparoscopic Tubal Reversal.

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