Introduction:
Tubal ligation is one of the most commonly performed operations in women in the United States. If you have had a tubal ligation in the past and currently desire to have more children, you could be a candidate for a microsurgical tubal reversal (also called microsurgical tubal anastomosis). More than 1% of surgically sterilized women ultimately seek restoration of their fertility.
What is a tubal reversal?
A tubal reversal is a surgical procedure during which the segment of the tube that has been tied is removed and the remaining 2 segments are attached together with the aid of an operating microscope.
Are both tubes "untied" during a tubal reversal?
Yes. More often than not, your doctor is able to reverse the ligation on both your right and left tubes. Occasionally, one side may be heavily scarred from the previous tubal surgery you have had and therefore only the other side is amenable for a tubal reversal. Very rarely are both sides heavily scarred and the operation cannot be performed.
If both sides are heavily scarred, does it mean I cannot get pregnant?
No. You can always undergo in vitro fertilization and therefore "bypass" the tied tubes.
How successful is a tubal reversal?
Depending on which method your tubes were tied, the success of microsurgical tubal reversal is anywhere from 60%to 80%. Your chances are higher if the remaining total length of the tube after it has been surgically put back together is more than 4 centimeters (a little less than 2 inches). Most patients who get pregnant after microsurgical tubal reversal do so in the first 6 months following the surgery, although some patients may take longer to conceive. If only one tube is successfully untied, your odds of getting pregnant are not decreased, but the time to get pregnant may be longer.
How is the surgery performed?
The surgery is performed in one of 2 methods. The classical method involves a small "bikini line incision", about 5 centimeters in length (or 2 inches). You will need to stay overnight in the hospital and will most likely be discharged the next day. The other method is done laparoscopically, and it involves 4 very small incisions (half a centimeter each). We are currently performing this procedure using the Davinci robotic system. This allows us to use the laparoscopic method with the same or better visualization than the open procedure. In addition, because of the smaller incisions, you are able to return to work much faster. You are typically discharged home the same day of your surgery. Ask your doctor which method suites you best.
Is the tubal reversal surgery good for one pregnancy only?
No. Once your tubes are successfully untied, you are able to get pregnant as many times as you need to. However, it is important to remember that if you desire to have only one child, you will need to use some form of contraception after you deliver.
What is the cost of tubal reversal?
Our "package price" for tubal reversal is $4300 and includes all surgeon's fees, operating room charges and recovery room charges. Additional charges include hospital stay ($350/night), and anesthesia charges ($375 for the first hour, then $168/hr thereafter).
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