How a Laparoscopic Tubal Reversal Differs

Another option for having a reversal done is with a laparoscope – a laparoscopic tubal reversal. Perhaps you have heard about this and are wondering just how it differs from the usual ways of reversing tubal ligation and if it would be the best choice for you.

A laparoscopic tubal reversal was first done by Drs. Koh and Janik in 1992. This means this is a relatively new procedure. In fact there is still much experimentation going on with it.

In a regular tubal reversal surgery, a 3-4 inch incision is made at the pubic hair line just above the pubic bone. In the laparoscopic procedure, several incisions are made. While the doctor you choose may still use the original five incisions, the originators of the procedure are down to four with only a 5 mm umbilical, two other 5 mm and one 3 mm incisions. With the original five cuts, the overall length was about 3 inches making that equivalent in total to the one incision of the traditional tubal reversal surgery.

Success Rate of Laparoscopic Tubal Reversal

Additionally the overall pregnancy rate appears to be less than with a traditional operation. The ectopic pregnancy rate ranged from 6 – 8%, or even higher, in the study summaries reviewed. An intra-uterine pregnancy rate appears to be getting better as time goes on but it is as low as around 30% up to about 70%. It would be best to learn the statistics of your particular doctor if you go this route.

Suturing Is Done Differently – Better or Worse?

Another factor brought out by researching the topic of laparoscopic tubal reversal is that as stated above, experimentation is on-going with this procedure.

To make this point, understand that there are three layers that make up the fallopian tubes which are usually sutured from the inside out in the more usual abdominal surgery. Some specialists suture just two layers and some all three.  Check out tubal reversal surgery to learn a bit more about this.

In a laparoscopic procedure, the fallopian tubes are not sutured together from the inside out. Take a look at the laparoscopic surgical tools in the image above and you might be able to understand why this is so.

Initially, the surgery was done with just four stitches to hold the two pieces of each fallopian tube together. Now you are likely to find only three or two used. There are even studies being done where only one suture is made that more or less just holds the cut ends of the tube together.

Overall, a laparoscopic tubal reversal is a specialized procedure…even more so than a regular tubal reversal. It requires specialized training and highly skilled surgeons. You will want to know just how many of these procedures your doctor has done before going ahead with it.

While the intent of this surgery was to be less invasive of the body, the way your tubes were originally “tied” has a major impact on whether this procedure can be done or not. This depends on how much of the tubes are left and other factors. So even with the best intentions of a laparoscopic tubal reversal, your doctor may still have to open you up.