East Coast Tubal Ligation Reversal Center Surgical Technique
The basic goal of this surgery is to open the area of fallopian tube blockage created by the tubal ligation. Tubal reversal or tubal reanastomosis is performed under general anesthesia. At the East Coast Tubal Reversal Center, the most common surgical approach, a mini-laparotomy, is about a 2 1/2-inch incision made in the lower abdomen and an operating microscope is brought into place.
The fallopian tubes are examined under the microscope and the site of tubal blockage is identified. The area of tubal blockage is microsurgically removed and the two open areas of the fallopian tube are spliced (reanastomosed) together. The fallopian tubes are small and delicate structures requiring tiny sutures-smaller than a human hair.
The surgery is conducted with care and great precision. Tubal reanastomosis usually takes 3 hours. There is minimal blood loss. At our center the fallopian tubes are successfully opened in almost every case. Most procedures are completed as outpatient surgery with recovery time at home for 2-3 weeks.
Patients seeking surgery who are overweight may be asked to lose weight in order to allow the surgery to be performed or may be offered to have the tubal reversal surgery performed laparoscopically. if the physician feels this is appropriate, a “laparoscopic” approach may be recommended in overweight patients where the abdominal wall is too thick to do the procedure using the more common and successful “minilaparotomy.” Laparoscopy is a minimally-invasive technique using a camera and long-handled instruments placed through 2-10mm ports in the abdominal wall. See our laparoscopic tubal reversal video for more details. There are instances where weight loss is required in order for surgery to be done.
In general, women over 200 pounds often have an abdominal wall thickness that is too large for the usual small incision (mini-laparotomy) to be made. But it depends on how tall you are and how your body fat is distributed. If you are over 200 pounds it does not mean the surgery cannot be done, rather our physicians maybe be able to offer the procedure laparoscopically. There is an upper weight limit at which it is possible to safely perform laparoscopy. If over 200 pounds, it would be best to work on weight loss in most cases.
Of course, we hope you will become pregnant soon after your surgery with us and having your weight in as good control as possible prior to pregnancy is important for the health of both mother and baby.
If you are over 200 pounds, we need for you to e-mail us a picture of yourself in a bathing suit or underwear and bra so we can see how your fat is distributed. If you are tall and fat is not mostly in the abdomen, we may be able to surgery without weight loss. Please e-mail appropriate pictures to Jody Halloran.
Tubal ligation reversal surgery is performed at the Martha Jefferson Hospital in Charlottesville. Martha Jefferson Hospital was named one of the “Top 100” community hospitals in the country. (Make sure your doctor does not own or operate any part of the surgery center where you will have your procedure.) Doctors Williams, Bateman and Smith have no ownership in this high-quality surgery center so no conflict-of-interest exists with referral of our surgery patients.
Are you being offered tubal ligation reversal with the “robot”? Ask your doctor why there are no studies showing “robot” surgery pregnancy rates are better. Also consider the additional cost of robotic tubal ligation reversal surgery.
We purposely do not offer robotic tubal ligation reversal surgery because it costs more and there is no research study demonstrating use of the robot is as good as or better than our standard technique of using a microscope and a single small incision in the lower abdomen, called a mini-laparotomy. Don’t you want the highest success rates possible?
We do offer laparoscopic tubal ligation reversal without the robot at the same price as mini-laparotomy. But, our experience is that the use of a microscope and mini-laparotomy gives the highest quality reanastomosis. A laparoscopic approach whether with a “robot” or without, does not magnify the surgery site. This is the advantage of using a microscope. In cases where a mini-laparotomy is not possible or ill-advised, then a laparoscopic, non-robotic approach will be discussed.