Our Technique of Laparoscopic Tubal Ligation Reversal
Laparoscopic Tubal Ligation Reversal, a minimally-invasive surgery, uses small, specially-designed instruments to repair and reconnect the fallopian tubes.
|

|
|
One of the ligated tubes showing a clip in place
|
After general anesthesia has been administered, we begin by inserting a 10mm (about 3/8-inch) tube just at the lower edge of the navel, and a special gas is pumped into the abdomen to create enough space to perform the operation safely and precisely.
The laparoscope (a telescope), attached to a camera, is brought into the abdomen through the same tube, and the pelvis and abdomen are thoroughly inspected. The tubes are evaluated and the obstruction (ligation, burn, ring, or clip) is examined.
|

|
|
With the clip removed, the tube is shown to be patent (open) up to the ligation site
|
Three small instruments (5mm each) are used to remove the occlusion and prepare the two segments of the tube to be reconnected.
A special instrument (tubal cannulator) is inserted into the uterus (womb) through the cervix, and the tube is threaded with a fine stent. This allows for improved alignment of the tubes, so a much better connection can be accomplished.
Tiny sutures (less than a hair in thickness) are carefully and meticulously placed to connect the two segments.
|

|
|
The stents facilitate orienting and stabilizing the tubal segments for placement of stitches
|
Once the connection (anastomosis) is completed, a blue dye is injected through the cervix, traveling through the uterus and tubes, all the way to the abdomen. This is to make sure the tubes have been aligned properly and that the connection is working well.
All instruments are removed, the air is extracted from the abdomen, and the patient is awakened and taken to the recovery room to be watched and cared for by the nurses, as well as by the anesthesiologist who makes sure the patient is comfortable and without pain.
On average, most laparoscopic tubal ligation reversal patients are ready to be discharged two to four hours later.
Patients are seen between 5-7 days after the tubal ligation reversal to look at the small incisions and remove any stitches if necessary. Most of the time, the few stitches that were placed will be under the skin and will be absorbed by the body, without need for removal.
|

|
|
With the anastomosis completed and stents removed, the tubes are shown to be patent all the way through
|
Laparoscopic tubal ligation reversal patients should wait three months prior to attempting pregnancy in order to give the tubes a chance to heal completely. Trying to conceive before then could result in an increased risk of ectopic pregnancy (pregnancy inside the fallopian tube instead of in the uterus).
All laparoscopic tubal ligation reversal procedures are performed by certified laparoscopic surgeons with 30 years of experience in laparoscopic surgery, using state-of-the-art equipment and instruments.