Tubal Reanastomosis (Tubal Reversal)

Tubal Reanastomosis (Tubal Reversal) is surgery to reopen, untie, or reconnect a woman’s fallopian tubes so she can become pregnant. A tubal ligation reversal, or Tubal Reanastamosis, is a surgical procedure to reverse a tubal ligation, sometimes referred to as “tied tubes.” About one million women in the United States undergo elective tubal ligation procedures each year, and many later seek the assistance of a surgeon to reverse them.

Before the Procedure

Prior to the procedure, your physician will need information on the type of tubal ligation that was performed. Patient records reveal this information and are extremely helpful for the surgeon to determine the best tubal reversal procedure. The details may also impact the procedure’s success rate. If the patient’s operative notes are not available, a diagnostic surgery might be required to see if a reversal is an option.

Your physician will also conduct a full physical exam—including blood and imaging tests—on you and your partner to determine your candidacy. One particular test is called a hysterosalpinogram (HSG), which uses dye and X-rays, or saline and air with ultrasound, to examine the length and performance of your remaining fallopian tubes.

 

Always tell your health care provider or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

During the days before the surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
• Ask your health care provider which drugs you should still take on the day of your surgery.

On the day of your surgery:

• You very often will be asked not to drink or eat anything for 6 – 12 hours before the surgery.
• Take the drugs your health care provider told you to take with a small sip of water. Your health care provider or nurse will tell you when to arrive at the hospital.

Tubal Reanastomosis (Tubal Reversal) Procedure

Tubal reversal surgery is done in a hospital or outpatient center. You will be given general anesthesia, which means you will be pain-free during surgery and unaware of the operation taking place. During the procedure, the surgeon places a small lighted scope, called a laparoscope, through the belly button and into the pelvis area. This allows the surgeon to look at the fallopian tubes and determine if reversal surgery is possible. If the tubal ligation can be reversed, the surgeon then makes a small surgical cut, called a “bikini cut,” near the pubic hair line. Microscopic instruments attached to the end of the laparoscope allow the surgeon to remove any clips or rings used to block your tubes, and reconnect the ends of the tubes to the uterus, using very small stitches.

The surgery usually takes about two to three hours.

Recovery after a Tubal Reanastomosis (Tubal Reversal)

Recovery time depends on the surgical method used to perform the tubal reversal. Tubal reversal is major abdominal surgery that is more difficult and takes longer to perform than the original tube-tying operation.

Some women may need to stay in the hospital for one to three days. Today, however, tubal reversal surgery is most often done using microsurgical techniques. An overnight hospital stay may not be needed. Women who have the microsurgical method usually go home the same day, typically within two to four hours after the surgery is complete.

The doctor will prescribe painkillers to help you manage any discomfort. Most women resume normal activities within two weeks.

Risks

All surgeries carry risks, even a Tubal Reanastomosis (Tubal Reversal). While rare, complications may include:

• Bleeding
• Infection
• Allergic reaction to anesthesia and medication
• Injury to nearby organs
• Scar tissue which obstructs the fallopian tubes