Tubal Reversal For Pregnancy
Tubal Ligation Reversal
Tubal Reversal is considerably more involved than the operation performed for the sterilization. This procedure employs the use of very thin microsuture to carefully put the tubes back together. In many respects, the operation is very similar to the delicate repair of small blood vessels and/or nerves that plastic surgeons perform in cases of hand injury. It is necessary to use an operating microscope or another magnifying source to adequately visualize the tubal anatomy.
There are two techniques to consider:
Surgical Tubal Microsurgery
Tubal microsurgery, or microsurgical tubal reanastamosis, is a procedure done under microscopic instrumentation to open and reconnect the fallopian tube segments that remain after a tubal sterilization procedure. In this procedure, a small incision is made just above the pubic bone. The fallopian tubes are brought into the incision, and damaged or scarred portions of the fallopian tubes are removed. Using suture that is too fine to be seen by the naked eye, the healthy segments of the fallopian tube are stitched back together under the microscope. At the completion of the operation, dye is injected through the uterus out of the fallopian tubes to determine patency. Patency rates are greater than 80% in most instances.
To minimize trauma to the abdominal muscles, the use of self-retaining retractors is avoided. To minimize pain, local anesthesia is applied to the skin, muscles, and connective tissues. These steps minimize tissue injury, bleeding, post-operative pain, and result in rapid patient recovery after the tubal ligation reversal.
Alternatives to tubal ligation reversal
At times, tubal ligation may have been done in a fashion such that tubal reversal may be impossible. For example, the whole tube might have been removed on both sides in a procedure called salpingectomy. In these circumstances In Vitro Fertilization (IVF) may be the alternative to tubal reversal. IVF is the process where, after inducing the follicles to grow, eggs are removed from the ovaries using ultrasound, and they are mixed in the laboratory with the sperm from the partner of the person who desires to get pregnant. Fertilized eggs (embryos) are then transferred to the uterine cavity to achieve pregnancy, bypassing the fallopian tubes. In circumstances where tubal ligation reversal is impossible or not desired, then IVF is an acceptable.
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RecoveryBleeding, infections, damage to the surrounding organs and complications due to anesthetic are rare side effects of tubal reversal surgery.