Sterilization Reversal

8 Things To Know About Tubal Ligation Reversal Surgery

How your tubal ligation reversal surgery is done depends upon the doctor and/or clinic you choose for the surgery. Each doctor seems to have strong reasons for how he conducts this procedure. Below you will learn some of the basics of how it is performed by a ob/gyn.

Essentially, during your original tubal ligation, your fallopian tubes were cut and then they are coagulated (actually with this procedure the steps are the other way around), clipped or otherwise made so the cut ends could not come into contact and thus preventing an egg from making the journey to the uterus. The first step in a tubal reversal surgery is to get access again to the fallopian tubes.

Actually, the first step may be a laproscopic view of the tubes to determine length and the overall health of all operating parts (ovary, fimbriae, uterus, etc.). This incision will most likely be made in your belly button. Next will come the actual incision for the tubal anastomosis itself.

Generally this is done just above and parallel to the pubic bone below the start of the pubic hair. It will be a 3 or 4 inch incision depending upon your surgeon. The next choice made will be how your doctor performs the surgery itself to remove the clips, cauterized areas, scars or whatever to have clean live tissue of the tubes to join. You will find some doctors swear by surgical microscopes and others have performed thousands of surgeries using surical loupes (magnifying lenses). Each has his reason for what he uses. Most likely it is a simple matter of how the surgeon was trained. You may wish to discuss this with your doctor, but perhaps looking at his success rate for patients with your given statistics (age, time since original surgery, previous births, etc.) will tell you more.

Your doctor will next use micro sutures to reattach the seperated parts of the fallopian tubes. If he is one that prefers to use a stent, this will be threaded through the fallopian tube from the uterus through the fimbriae first to be sure there is no blockage within the tubes themselves. Some doctors do not use a stent because they believe it may cause some tissue damage itself. Those that do use it point to statistics which show a higher rate of pregnancy if one is used.

Once the seperated parts of the tubes are brought together, there are three layers where the micro sutures can be applied. Whether all three layers have sutures or only the outer most two (muscularis and serosa) again depends upon your surgeons preference and experience. The extra layer (lumens) will require more time for the surgery and you being under anesthesia which some doctors will try to avoid. The longer you are under, the more that can happen.

The form of anesthesia that is used may be a general which puts you under or an epidural so only sensation in the area of the surgery is blocked. You may be able to ask your doctor for the one you prefer. This decision could also be up to the anesthesiologist.

Lastly, if a stent was not used, your fallopian tubes may be flushed with saline solution or a chromotubation will be performed. Essentially this is flushing the tubes with a dye to check to see if they are open.

Lastly, the sutures used in the tubal ligation reversal surgery may be permament or they may dissolve. This will vary with location and your chosen doctor's preference based on his experience and surgical methods. This applies to the sutures on the fallopian tubes as well as the suture(s) used to close the incision. Whether you just clip off the knot on both sides of the incision or clip on one side and pull depends upon whether dissolving sutures were used or not. Be sure to follow your doctor's post-op care instructions to the letter.

Copyright 2007, Sandra Wilson