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Tubal Ligation Reversal


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Tubal Ligation Reversal

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Tubal ligation reversal - or tubal reversal for short - is a general term for a surgical procedure that can restore fertility to women after a tubal sterilization. Tubal reversal encompasses various operations - tubal anastomosis, tubal implantation, and ampullary salpingostomy.

Just as a tubal ligation is considered to be major surgery, so is a tubal reversal. Normally, this procedure takes two to three hours and is done under general anesthetic. In order to make your fallopian tubes functional again, the doctor will unclamp; reattach; remove any devices that may be blocking your tubes or place an implant into your fallopian tubes. This type of surgery does require a hospital stay of at least one night but you may need to remain in the hospital for as much as five days after the surgery. Once you leave the hospital, you can expect to completely recover from the procedure over the course of the next four to six weeks.

Tubal reversal procedures

There are three main types of tubal reversal operations. They are : -
  • Tubal anastomosis
  • Tubal implantation
  • Ampullary salpingostomy
The choice of the proper reversal operation depends on the type of tubal sterilization that was performed and the resulting tubal anatomy at the time of the reversal procedure. Sometimes, more than one type of tubal reversal procedure may be needed to repair the tubes.

Tubal anastomosis

Most tubal ligation procedures separate the fallopian tube into two segments. After the blocked ends of the tubal segments are opened, a narrow stent is gently passed through the tubal lumens (inner cavities) and into the uterine cavity. This ensures that the fallopian tube is open and that the two segments are perfectly aligned. The tubal openings of the two segments are then drawn together with a retention suture in the tissue that lies just beneath the tubes (mesosalpinx). Microsurgical sutures are then used to join the muscular portion (muscularis) and outer layer (serosa) of the two tubal segments.

Sutures are not placed through to the inner layer (endothelium) because suture material is a foreign body that could stimulate an inflammatory reaction resulting in scar formation. When the anastomosis is done, the stent is withdrawn from the fimbrial end of the tube. Tubal anastomosis is also called tubotubal anastomosis or tubal reanastomosis.

Tubal implantation

In some cases, a tubal ligation procedure leaves only one segment which has been separated from the uterus and no segment attached to the uterus at all. This is most likely to occur when the isthmic or uterine part of the tube has been burned by the technique of monopolar coagulation. In this situation, a skilled tubal reversal specialist can make a new opening through the uterine muscle and the remaining tubal segment inserted directly into the uterus. This is called tubal implantation or tubouterine implantation. This tubal reversal technique is somewhat more complicated than tubal anastomosis. Accordingly, there are few doctors with experience performing tubal implantation.

Ampullary salpingostomy

Fimbriectomy is a relatively uncommon type of tubal ligation that removes the fimbrial, infundibular and part of the ampullary segments of the fallopian tube nearby the ovary. After fimbriectomy, the single tubal segment that remains connected to the uterus can be opened by the technique called ampullary salpingostomy or neosalpingostomy. The closed tubal end is opened and the internal lining folded out over the end of the tube. Microsurgical sutures are used to keep the endothelial lining folded outside the tubal opening and to prevent the tube from closing again.

Am I a Candidate for Tubal Reversal?

Not all women who have had a tubal ligation will be able to have the procedure reversed. During your initial assessment for the procedure, your fertility specialist will examine the current health of your fallopian tubes, most likely through laparoscopy. She will also look over the surgery and pathology reports from when you originally had the procedure done.

Your specialist will also consider the following factors : -
  • How your tubal ligation was done (whether your fallopian tubes were cut, tied, cauterized or non-surgically blocked)
  • At what point in your fallopian tubes the sterilization took place
  • Just how much of your fallopian tube is left
  • How healthy your fallopian tubes are
  • Your age

For more information, medical assessment and medical quote
send your detailed medical history and medical reports
as email attachment to
Email : - info@selectsurrogacyindia.com

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