Tubal Reversal by Tubal Anastomosis
Tubal Reversal Procedures
There are 3 types of tubal reversal procedures:
- anastomosis – (today’s blog topic)
- implantation
- salpingostomy
Anastomosis of Fallopian Tubes
Anastomosis connects two body parts. Tubotubal anastomosis is connecting two segments of the fallopian tube. Tubotubal anastomosis is correct medical terminology, but it is also called tubal anastomosis for short. Bilateral tubal anastomosis means that both tubes are repaired by the anastomosis technique. The anastomosis sites can be specified for each fallopian tube. They may be different for the two sides. For example, a patient may have a right isthmic-ampullary tubotubal anastomosis and a left ampullary-ampullary tubal anastomosis. Sometimes, only one fallopian tube is repairable with the anastomosis technique. This is called unilateral tubotubal anastomosis.
Bilateral Tubal Anastomosis
Most tubal ligation operations separate the fallopian tube into two segments. Bilateral tubotubal anastomosis, therefore, is the most common tubal reversal procedure. Bilateral tubal anastomosis accounts for 90% of the tubal reversal procedures at Chapel Hill Tubal Reversal Center.
How I Perform Tubal Anastomosis
After opening the blocked ends of the two tubal segments, I pass a flexible stent or thread through the tubal lumen or opening of the two segments until it reaches the uterine cavity. This ensures that the fallopian tube is open from the uterine cavity to its fimbrial end and that the tubal segments align properly. A suture placed in the connective tissue, just beneath the fallopian tube segments, draws the tubal segments together.
The muscular and outer layers of the tubal segments are connected with microsurgical sutures. Care is taken to avoid suturing the inner layer of the fallopian tube. Suture material is a foreign body. Stitches placed in the inner tubal lining can cause scarring inside the tubal lumen. When the two tubal segments are joined together, the stent is withdrawn from the fimbrial end of the tube.
Watch The Operation
The images above illustrate the principles of tubotubal anastomosis. For more details, you can watch the operation as it is being performed. A short video clip online gives an overview. If you want to watch the entire tubal anastomosis procedure, you can order a videotape or dvd of Tubal Ligation Reversal by Dr. Berger as shown on TV by the Discovery and Learning Channels. Watching the full length video will help you better understand how I perform tubotubal anastomosis as outpatient tubal reversal surgery.
September 12th, 2009 at 5:01 am
The primary risk of tubal reversal is the risk of ectopic pregnancy, approximately 15%.
September 11th, 2009 at 10:50 pm
What is the risks for the tubal reversal? Please email me back at bkelly850@gmail.com.
May 18th, 2009 at 6:06 am
Si usted no está teniendo períodos menstruales desde su ablación endometrial, no hay un tratamiento que puede restablecer el endometrio.
May 18th, 2009 at 2:29 am
Doctores por favor estoy ala espera de uan respuesta ,,quiero saber si por la realizacion de una ablacion del endometrio no sera posible tener un bebe ,,digamen por favor si existe un medicamento o un tratamiento el cual yo debe hacer para la reconstrucion de mi endometrio ,,les suplico contestenmen y ayudenmen por favor
March 25th, 2009 at 10:23 am
Gracias DOCTORES por darnos una esperanza para poder nuevamente tener bebes ,,mi caso es el siguiente en septiembre del 2005 me ralizaron la pomeroy decicion que tome apresuradamente por circunstancias de la vida ,,en octubre del 2008 me realizaron la ablacion del endometrio por algunos miomas que padecia,,hoy la vida me ha brindado nuevas iluciones y desearia poder tener nuevamente un bebe con mi actual pareja,,quisiera saber si esto es posible ,,que debo hacerme ,,a donde acudir y si la ablacion del endometrio podria perjudicarme o como podria ser posible nuevamente un embarazo ,,deme su consejo se lo agradeceria muchisimo ,,que DIOS lo siga bendiciendo hoy y siempre
September 17th, 2008 at 7:23 pm
[...] more details about untying tubes via tubal anastomosis, see the topic on Tubal Reversal by Tubal Anastomosis on the Tubal Reversal Blog and the description of Microsurgical Tubal Anastomosis on the Chapel [...]
April 30th, 2008 at 8:19 pm
[...] Today we had another successful day of untying tubes. We began the day at 7AM. Four patients were scheduled for tubal ligation reversal surgery. [...]
January 31st, 2008 at 4:01 pm
[...] anastomosis is a tubal reversal procedure that is intermediate between tubotubal anastomosis and tubouterine implantation. It is also called cornual anastomosis because the tube is joined to [...]
December 2nd, 2007 at 12:57 pm
I believe this blog topic will be very helpful to patients and potential patients. Without illustrations and detailed explanations, it is often difficult for a non-medical person to understand what happens during a tubal ligation and during the reversal.
Thanks Dr. Berger.