Tubal Ligation And Reversal

Tubal reanastomosis or tubal reversal, a surgical method used to reverse tubal ligation (an operation to prevent pregnancy by the surgical tying, or burning, of the fallopian tubes to prevent passage of eggs from the ovaries to the womb) may be an option for women, who for various reasons, wish to reestablish their fertility. All Cleveland Clinic physicians have special training in obstetrics and gynecology, reproductive endocrinology and infertility and microsurgery.

What does the operation involve?

Tubal reanastomosis is a two to three hour operation performed under general anesthesia (being put to sleep). Usually, laparoscopy (placing a small scope through the navel) will first be done to evaluate the reversibility of the tubes. If conditions are appropriate, a bikini cut, a small (side to side) incision, is made just above the pubic hair line. An operating microscope is used to connect the small ends of the tube together with very fine suture material.

Typically, an overnight hospital stay is not necessary. After surgery, your physician will provide instructions and pain medications to take at home. Most patients return to normal activities within two weeks.

What are the risks?

Risks are extremely rare but, as in any operation, include anesthetic complications, bleeding, infection or damage to other organs may occur. After tubal reversal, the risk of ectopic pregnancy (tubal pregnancy) increases from 1 in 100, to 5 in 100 pregnancies.

Is the operation covered by insurance?

Please check with your individual insurance carrier to determine if this procedure is covered, since often times this procedure is not covered.

Are you a candidate for tubal reanastomosis?

You are a candidate if there are no medical contraindications to pregnancy, you have adequate tubal segments and your partner's sperm analysis is normal. Keep in mind that older women have a greatly reduced chance for success.

What is required prior to surgery?

• medical history and physical examination.
• male partner's sperm analysis
• copies of your operative report and pathology reports for the sterilization procedure at the time of your initial office visit will be helpful.
• You may also be required to have additional x-rays, blood work and/ or fertility tests prior to surgery.

Preoperative instructions:

1. Schedule your surgery within the week following the end of your period.
2. Do not eat or drink anything (even water) after midnight the day of surgery.

After surgery

You will remain in the hospital for approximately three hours after the completion of your surgery before discharge. If you are not ready to go home, you may spend the night in the hospital at no extra charge. You should refrain from heavy lifting, otherwise there are no diet or activity restrictions. You should take your medications as directed.