Tubal Reversal Procedures

The most common method of tubal reversal surgery is tubal anastomosis

The type of microsurgical technique used to repair the fallopian tubes depends on how much of the tube segments are left. Your physician will be able to determine this by your operative report obtained from the surgeon who performed your tubal ligation. If an operative report is not available, a screening laparoscopy can be performed to view your fallopian tubes.

Tubal reversal through microsurgical tubal anastomosis

tubal-anastomosis2(yellow)tubal-anastomosis1(yellow)Usually there are two fallopian tube segments remaining after tubal ligation surgery – the proximal tubal segment that is connected to the uterus and the distal tubal segment that ends with the fimbria next to the ovary. The procedure that connects these separated parts of the fallopian tube is called microsurgical tubotubal anastomosis, or tubal anastomosis for short. Other terms used to describe this procedure are microsurgical tubal reanastomosis, microsurgical tubal reversal or microsurgical tubal repair.

After opening the blocked ends of the remaining tubal segments, a narrow flexible stent is gently threaded through their inner cavities or lumens into the uterine cavity. This ensures that the fallopian tube is open from the uterine cavity to its fimbrial end.
The newly created tubal openings are then drawn next to each other by placing a retention suture in the connective tissue that lies beneath the fallopian tubes. The retention suture avoids the likelihood of the tubal segments subsequently pulling apart.

Microsurgical sutures are used to precisely align the muscular portion and outer layer. The tubal stent is then gently withdrawn from the fimbrial end of the tube.