Tubal Reversal Blog June, 2008

Chapel Hill Tubal Reversal Center is the only medical facility specifically for tubal ligation reversal surgery. We provide the most detailed and accurate information about tubal reversal available from any doctor, hospital, or medical institution. Let me explain how we are able to do this.

Electronic Patient Database

Keeping track of patients following surgery makes excellent sense from a clinical point of view. Continuing follow-up after surgery helps ensure the best care for each patient and allows us to evaluate the success of tubal reversal surgery and the care we provide. Setting up and maintaining a system to ensure ongoing follow-up is not usually found in a private medical practice since this is costly and time-consuming and requires staff knowledgeable in database management. Regardless of the cost and time requirement, Dr. Berger has made it a priority because of his commitment to giving patients all of the information they should have in order to make an informed decision about tubal reversal surgery.

At Chapel Hill Tubal Reversal Center, we have a computer system where every nurse enters patient information before, during, and after their surgery. In fact, all 11 of our nurses contact patients, record data, and make daily entries into computerized records. With this follow-up information, we can analyze and report accurate statistical data about the long-term outcomes of tubal reversal procedures performed here.

Information Sources

The patient follow-up system consists of information collected in many different ways and includes a minimum of 6 calls or e-mails to the patient in the first year following surgery.

1. Post-operative nurse visit the morning after surgery
2. Telephone follow-up on the second postoperative day
3. Telephone follow-up on the third postoperative day
4. E-mail questionnaire at two weeks
5. Telephone contact at 6 months
6. Telephone contact at 12 months

Other information is collected and recorded any time we communicate with patients post-operatively. These contacts are usually initiated by patients to report pregnancies and the outcomes of pregnancies. When patients report new pregnancies, we request that they complete a Pregnancy Report Form. Each week, we summarize the new pregnancy results in the Weekly Pregnancy Report Forum of the Tubal Reversal Message Board and also give more details in the New Pregnancy Announcements.

Summary

After reading our information and statistics and comparing it to what might be available from other doctors, we believe patients will recognize that Chapel Hill Tubal Reversal Center is the only facility where accuracy of information is considered to be a priority and sharing it with prospective patients is considered to be a necessity. Providing facts rather than offering misleading or speculative statements about tubal reversal success is one mission of our practice. We believe this is the right thing to do.

I hope this information is helpful to you as you consider whether tubal reversal surgery is right for you, and if so, why it is in your best interests to have it performed at Chapel Hill Tubal Reversal Center.

Submitted by Julia Smith RN
Nurse Administrator
Chapel Hill Tubal Reversal Center
919-656-8204

Sally Muncy, R.N.
Chapel Hill Tubal Reversal Center

Introducing Myself

Dr. Berger has asked me to give a short description of what I do as an Operating Room Nurse so that you will feel that you know me when you come here for your tubal reversal surgery. I am a nurse who accompanies you to the operating room once the preoperative nurses have admitted you and taken care of all your physical as well as emotional needs. I am there for you to make sure that you are comfortable and have no last minute questions or misgivings.

One more time I will check your name on your name band and ask you about allergies and if you have eaten. I will ask you to use the rest room to empty your bladder as Dr. Berger does not use any bladder catheter in your bladder during surgery. I’m not asking these same questions that the other nurses have ask you because I don’t know the answers, but ask them only as one more opportunity to avoid a mistake about something you may have forgotten to mention.

In The Operating Room

In operating room, you will be made comfortable and warm and everything that is being done will be explained to you. I realize this is a little frightening since everyone in the operating room wears a mask, gloves and gown for your protection. This brings up another point about who will be in the operating room with you. As I said I will be at your side the whole time. There will also be an anesthesiologist or anesthetist, a surgical assistant, and a surgical scrub technician (the person who is responsible for all the sterility of the surgical equipment and for seeing that Dr. Berger has the instruments as he needs them when he is concentrating on surgery). The only other person present is Dr. Berger.

For those of you (and there are many) who have a concern for modesty in the operating room, you really have nothing to worry about. After the surgical area is cleansed you are covered from head to toe. There is only about an 8 inch by 3 inch window of skin exposed on your abdomen. Many ladies also come for surgery while having their menstrual period. This also is handled very discreetly. You will keep your underwear and pad on until the last minute and then you can remove them in the bathroom and we will have a pad on the bed for you. I really want to impress upon you that from the time you walk in the front door to when you leave after surgery you will be treated with the utmost respect and dignity.

Once you are settled in the operating room you go off to sleep fairly quickly after being attached to heart monitors and a final safety check being done. One more time every staff person in the room checks your name, allergies, and other important data regarding your health. At this point everyone takes their designated position in the room and like a finely choreographed dance surgery begins. Because of keeping sterility in the room, no one can touch another person so each one has to know exactly what they are doing and where the other four people are.
I am the one who keeps computer records of anything pertinent to your surgery while Dr. Berger dictates in detail. I am also responsible to see that everyone has the sterile equipment, medications, irrigating fluids, or anything else that needs to be brought in to the operating room. And finally I perform, with the scrub technician, a counting of all the instruments and dressings that are used during surgery. This count is also done before you enter the room and two more times. The final count must match exactly. This avoids any concern of a lost instrument or dressing. This is to insure absolute safety.

On To The Recovery Room

When Dr. Berger finishes surgery I will put a small dressing on your abdomen. Surgical time will be recorded and you will soon wake up and move back to your original bed. It is then my pleasure to return you to the recovery room where your nurse will greet you and I will bring your family member in to sit with you.

I just want to assure you once again that you will be in good, safe hands throughout your tubal reversal surgery. Every staff member at Chapel Hill Tubal Reversal Center and Chapel Hill Surgical Center is there to meet your needs and we are honored that you have put your trust, first in Dr. Berger, and then in everyone else who has any part in your care.

hope (hp)v.t. & i, expect or look forward to, with desire and confidence. –n. 1, confidence in a future event; expectation of something desired. 2, what is hoped for. 3, something that arouses or justifies hope.

At Chapel Hill Tubal Reversal Center, Dr. Gary Berger understands that hope is not just a word to the hundreds of women who come to his center each year. Hope is what they find in him.

When Amanda Nelson first decided to have a tubal ligation in 1997, she never imagined she would find herself in Chapel Hill, North Carolina, 4,000 miles away from her home in Cumbria, England about to undergo a tubal ligation reversal.

“I had been married for a number of years when my marriage broke down,” said Amanda. “I had two boys to look after, so I waited a year and then went ahead with my tubal ligation. At the time, the thought of having children with a different father didn’t appeal to me.”

Like Amanda, many women who come to Chapel Hill Tubal Reversal Center have faced life changes such as divorce, loss of a child or remarriage.

“Years went by, and then I met David. He had no children and happened to mention he would like one of his own some day,” said Amanda. “It took me awhile to think about it, but decided to look up having the operation.”

The couple sought the advice of Amanda’s local gynecologist. She suggested that they try in-vitro fertilization. But due to the high cost and limited chance of conceiving, the couple decided to begin researching tubal reversal surgery.

“David and I came to the conclusion that you only get one chance with IVF, and if it didn’t work, you have to start all over again,” said Amanda. “The emotional side of it and the high cost put us off.”

The Search Begins

The couple began searching online for tubal reversal specialists. Their search brought them to the Chapel Hill Tubal Reversal Center Web site and Dr. Gary Berger.

“My doctor said we would have more of a chance of getting pregnant if the surgeon had done the operation many times,” said Amanda. “ I couldn’t believe my luck when I found Dr. Berger.”

Over the past 28 years, Dr. Gary Berger has performed over 7,000 tubal reversals as a one-hour, outpatient operation. Recognized as a leader in the field, Dr. Berger has been featured on The Learning Channel and Discovery Health.

Patients come to Chapel Hill from across the United States and abroad to have him perform the procedure. Using microsurgical techniques he developed and refined, Dr. Berger can successfully repair the fallopian tubes in 98 percent of the women who want their tubes untied.

“At first it seemed silly to travel that far to have surgery,” said Amanda. “But when David and I read the Web site and learned about Dr. Berger, we knew he was the man for the job.”

On April 1, Amanda contacted the center to schedule her tubal reversal surgery. After completing the required forms and health history with a tubal reversal nurse, Amanda was ready to begin her long journey to North Carolina.

When the couple arrived at the Raleigh-Durham International Airport in late May, they were greeted by Janice Barrett of Red Carpet Coach, a transportation service that offers discounted rates to Dr. Berger’s patients.

“Janice picked us up and gave us a little tour of the town,” said Amanda. “She drove us by Dr. Berger’s office, then to the hotel. It was nice knowing we were close by.”

Dr. Berger’s patients stay at the Sheraton Chapel Hill Hotel, where they receive a discounted rate. This convenient location allows for quick and comfortable access to the hotel following surgery.

The First Meeting

On the morning of her surgery, Amanda and David arrived at the center for a patient consultation and first meeting with Dr. Berger. As Amanda describes, her first meeting with Dr. Berger was a special experience.

“I remember years ago watching a television show on the Discovery channel about a lady having the tubal reversal surgery and Dr. Berger was on it,” said Amanda. “Being on his Web site most days, I used to look at his photo and think, it won’t be long now before I’m in Chapel Hill. So when I finally met him, it just felt special…he was a star, and a humble one at that.”

Immediately following her operation, Amanda was alert and comfortable. David arrived shortly in the post-anesthesia care unit to be by her side.

“I woke up from surgery to my David, and I was in no pain,” Amanda said. “I was shocked because when I had my tubal ligation, I woke up in extreme pain, so I was really pleased. I was given time to wake up and told the good news by Dr. Berger that everything went well and my tubes were repaired.”

Most women are typically discharged from the facility within two hours after surgery. And most resume normal activities within five to 10 days. This outcome is far better for patients than the standard approach to tubal ligation reversal that requires hospitalization for several days, longer recovery times and unnecessary hospital costs.

“I didn’t experience any pain the day of my surgery,” said Amanda. “And I was able do a little sightseeing of Chapel Hill the day after my surgery.”

Home Sweet Home

After returning to England, Amanda joined the Chapel Hill Tubal Reversal Center message board. The message board is a place for patients and those interested in tubal reversal and women’s health issues to share their stories.

“The Web site is wonderful,” says Amanda. “I’ve found the message board to be very helpful, and I’ve managed to help some future patients of Dr. Berger’s that live here in the UK.”

When asked to describe her experience in Chapel Hill, Amanda gave two words…first class.

“My experience was better than I expected,” said Amanda. “David was very happy with the care I received, and I think he enjoyed the care he received, too. You don’t leave the men out, I think that’s important.”

Giving hope to patients is something Dr. Berger and his team of tubal reversal professionals doesn’t take lightly. Hope isn’t just a word; it’s their mission.

Learn More

To learn more about Dr. Gary Berger and his team at Chapel Hill Tubal Reversal Center, visit www.tubal-reversal.net or call 919.968.4656.

Submitted by Lisa Hourmouzis, RN
Tubal Reversal Nurse

My training in residency taught me that Post Tubal Ligation Syndrome (PTLS) was a dirty little phrase used by ill-informed doctors to describe the observed, normal aging process in women after a tubal ligation. No one who has taught me that concept has ever met Momzilla. Momzilla is her sign-on name, which she gave me permission to use, for the Chapel Hill Tubal Reversal Center message board.

Momzilla came to us at Chapel Hill Tubal Reversal Center seeking relief of problems that occurred after her tubal ligation. She is currently 43 years old, is happily married, and has three children. She is employed as a human resource manager and her husband is an attorney.

Momzilla had her tubal ligation three years ago and she describes the gradual onset of symptoms after her tubal ligation. I asked her if we could use her as the subject of a blog featuring our patients. She agreed and after her surgery she emailed me a comprehensive list of her physical problems. Below are her symptoms in her own words,

“Longer clotty periods with a day or so of flooding blood followed by nothing and then bleeding again. (My menstrual periods from the dawn of time prior to that had been regular and predictable to almost the day), horrible insomnia, light-headedness/dizziness (almost passing out on a few occasions), exaggerated PMS and mood swings, absence of libido and an aversion to sex, fatigue, a sense of dread or doom (not depression), withdrawal from my family (almost needing isolation from people), inability to concentrate, fogginess and an awful memory, tingling in extremities, very dry skin no matter how much I drink or how much lotion I used, more frequent headaches, bloating and GI issues, inability to lose my baby weight (I lost my waist), breaking hair that is more oily, breaking nails, changes in perspiration and body odor (sweating and smelling more easily), bad taste in my mouth, more sinusitis and allergies…I think that about covers it..”

She also had told us she had tingling in her legs, which required her to see a neurologist and have a brain MRI. She also increased sugar cravings and gained 15 lbs.

Momzilla told us her story of having a tubal ligation and then noticing the onset of these symptoms. She has seen several doctors and had a variety of inconclusive tests. She found information about PTLS on the Internet and discovered Chapel Hill Tubal Reversal Center as well. She was very clear she was not getting a ligation reversal so she could have more kids. She was trying to get her body to be like it was prior to the ligation. She desired a return to her normal state.

I am happy to report Momzilla had a successful tubal ligation reversal. Her surgery went well with Dr. Berger acting as the primary surgeon and me as the assistant. She had good tubal lengths and did well in the recovery room.

Momzilla has kept in touch with us since her surgery and we hope she has a good and speedy recovery. We hope her symptoms abate and we have asked her to keep us closely updated on her progress.

Submitted by Dr. Charles Monteith
Chapel HIll Tubal Reversal Center

Over a year ago, I approached Dr. Berger at Chapel Hill Tubal Reversal Center to start a new career as a tubal ligation reversal specialist. When I started to pursue my interest and training in tubal reversal surgery, I naively thought that only women who wanted to have another child had their tied tubes untied. I have come to realize that some women seek to have their tubes untied for many reasons other than to have another child after tubal ligation.

Of course the number one reason is to have more children, but there are many more and equally important reasons patients give. Some common reasons patients come for tubal ligation reversal are to:

• relieve symptoms associated with a tubal ligation (PTLS)
• feel whole again
• be like God intended them to be
• comply with their religious tenants
• feel more like a woman
• relieve regret of a prior mistake
• correct a decision made during a bad relationship
• fill the emptiness from the loss of a child or another loved one

As a generalist ob/gyn, I was always keenly aware of how many women bore both the burden of having children and the burden of sterilization. It was only after I became a ligation reversal specialist I saw how heavy the burden of tubal ligation could be. Now I have the opportunity to help in these situations and feel gratified that my training as a tubal reversal surgeon is progressing nicely under Dr. Berger’s mentorship.

Submitted by Dr. Charles Monteith
Tubal Reversal Specialist
Chapel Hill Tubal Reversal Center

One of yesterday’s patients is a 33 year old from West Virginia. She works as a facilities assistant in a maximum-security prison. She has three children ages 15, 11, and 10. After her last child she had her tubes tied. She was previously married but now has a new partner. Her partner does not have any children and together they desire a child.

She found Chapel Hill Tubal Reversal Center by researching tubal ligation reversal on the Internet. She says it took some time for them to decide and make up their mind where to have her tubal reversal operation performed. They decided to come to us because of our reputation and informative website.

Dr. Berger and I meet with her and her husband the morning of surgery. We discussed her medical history, risks of surgery and expected recovery. After our pre-operative evaluation, she and her husband met the anesthesiologist, Dr. Caryn Hertz, and within one hour she was in the operating suite.

She underwent general anesthesia without any difficulty. She had a small 3-inch incision just about the pubic hairline. Both tubes were easily identified and repaired. The tubal lengths after the tubal reapproximation were good. The entire surgical procedure was one hour. Her surgery went extremely well.

After her stay in the recovery room, we discussed the operative results with her and her husband and the recovery room nurses reviewed the postoperative instructions with them. They were discharged to stay at a local hotel where one of the Tubal Reversal Nurses visited her this morning. She was found to be recovering well and she was discharged to return home to West Virginia.

We wish her and her husband well and that they will have the baby soon they are hoping for!

Submitted by Dr. Charles Monteith
Chapel Hill Tubal Reversal Center

Submitted by Dr. James Split
Anesthesiologist
Chapel Hill Tubal Reversal Center

At Chapel Hill Tubal Reversal Center, we use general anesthesia for our tubal reversal surgeries. You will be completely asleep through your operation. When under general anesthesia, you will be totally unconscious and will not be able to feel any pain. In addition to the general anesthetic, your tubal reversal surgeon will place local anesthetic into the skin and deeper structures that are operated on to help you be as comfortable as possible when you wake up.

You will have an IV started after you arrive at the surgical center on the morning of your tubal reversal procedure. After you arrive in the operating room, we will give you an intravenous sedative similar to Valium to help you relax prior to going to sleep. We will take a blood pressure reading and then ask you to take several deep breaths of oxygen through a loosely applied face mask. We will put a sedative medication into your IV line that will make you fall asleep very quickly, usually in 10 to 20 seconds. We will keep you asleep during your surgery by having you breathe an anesthetic gas. During your operation, you will be given additional IV medications to prevent post-operative nausea and vomiting, and to minimize pain when you awaken.

We usually place a soft airway in your mouth after you are asleep. This airway is positioned behind your tongue to keep your airway open. This allows us to be sure you always have a safe open passageway for oxygen to enter your lungs. This airway goes into your mouth after you are asleep and is removed when you awaken. Most patients do not remember having a soft airway in their mouth, but some patients will have a scratchy or sore throat for 12 to 24 hours after surgery.

The anesthesiologist or nurse anesthetist will always remain with you while you are asleep. Throughout your tubal reversal procedure, we will monitor your blood pressure, heart rate, temperature and oxygen concentration in your bloodstream. You will awaken quickly after your surgery. Most patients are able to move themselves off the operating room table onto the stretcher to be taken into the recovery room.

Sometimes patients ask if they can have conduction anesthesia such as an epidural. We do not use epidural as outpatient anesthesia because of the risks involved. The method of general anesthesia that we use is safer than conduction anesthesia in the outpatient setting and less likely to cause a complication requiring hospitalization.

Many women who have had a tubal ligation find themselves considering tubal ligation reversal. We have patients who come to Chapel Hill Tubal Reversal Center from all areas of the United States, Europe and Asia for ligation reversal procedures. They come to have their tubes untied for a variety of reasons. Many patients have told us about the frustration they felt when talking to their ob/gyn doctors about tubal ligation reversal or to a reproductive specialist who recommended only in-vitro fertilization (IVF). Many patients have also said their doctors minimize their concerns about symptoms they developed after having their tubes tied.

We recently published a blog about why some doctors may have negative opinions regarding ligation reversal surgery: Why your doctor may be cold to the idea of tubal ligation reversal. We also went to our message board and asked our patients and prospective patients about personal experiences with their physicians when talking about ligation reversal surgery. There we found out that many doctors were very supportive of their patient’s desire to have reversal surgery. The responses can be read under the message board topic: Share your doctors’ attitudes about tubal ligation reversal. Please feel free to leave your story about your experience when seeking reversal surgery or your doctor’s attitude toward the surgery. To leave comments on the Tubal Reversal Doctors Blog, please register and then log in (right hand column). Alternatively, you can add posts to the message board topics shown above.

At Chapel Hill Tubal Reversal Center, we are committed to providing you with the information you want to know about. That’s why the Chapel Hill Tubal Reversal team welcome your ideas, questions and comments. Whether you’re wondering about tubal reversal pregnancy rates, PTLS or how to talk to your doctor about having your tubes untied, we want to be able to address your concerns about tubal ligation reversal.

Submitted by Dr. Charles Monteith
DrMonteith@tubal-reversal.net

We recently asked Tubal Reversal Message Board members to submit ideas for future topics to be addressed in the Doctors Blog.

Here are some of the topics that have been suggested so far:

• Tubal ligation effects on a woman’s body
• Tubal ligation risks
• Pregnancy outcomes and other issues for older women
• Information to help educate doctors

If you would like to add suggestions for other topics, please post on the Doctor’s Blog Suggestions thread on the message board.

At Chapel Hill Tubal Reversal Center, we are dedicated to patient education about all aspects of tubal ligation reversal. We welcome your ideas and want to address your questions and concerns about tubal ligation, tubal reversal or pregnancy after a tubal ligation reversal.

Submitted by Dr. Charles Monteith
Chapel Hill Tubal Reversal Center
DrMonteith@tubal-reversal.net

Women who want more children after tubal ligation must decide between two treatment options:  In-vitro fertilization (IVF) and tubal ligation reversal.

In-Vitro Fertilization (IVF)

This medical treatment involves controlling the woman’s natural cycle with hormone injections that stimulate the ovaries to produce a large number of eggs. The eggs are retrieved from the ovaries, combined with sperm in a laboratory and the fertilized eggs are placed inside the uterus. A single course or cycle of treatment takes three to eight weeks. The success rates are variable and depend on the reasons for infertility. In general, success rates per cycle are 10 to 30 percent.

Most IVF specialists advise patients to start the process by planning to undergo at least three cycles. The average cost of a cycle in the US is approximately $10,000 to $12,000, and can be as high as $20,000. Recently CNN and the NY Times have reported on the costs of in-vitro fertilization.

The most serious risk of IVF is ovarian hyperstimulation syndrome (OHSS). Ovarian hyperstimulation syndrome may be classified as mild, moderate or severe. The worst cases are associated with pregnancy since HCG (the pregnancy hormone) continues to stimulate the ovaries. Severe OHSS is a life threatening complication.  Despite careful monitoring, up to 33 percent of IVF treatments has been reported to be associated with mild forms of OHSS. Severe OHSS has been reported in three to eight percent of IVF cycles. Other risks of IVF are multiple gestations (30-50 percent) and ectopic pregnancy (three percent).

Tubal Ligation Reversal

This surgical treatment involves reattaching fallopian tubes that have previously undergone surgical separation (tubal occlusion or tubal ligation). The surgery time can range from one to five hours, and the average costs in the US can be $8,000 to $9,000, but can be as high as $25,000. Approximately 70 percent of patients who undergo tubal ligation reversal will become pregnant. Pregnancy rates for reversal depend on the patient’s age and the method of tubal ligation, and can range from 20 to 80 percent. The main risk of tubal ligation reversal is an increased risk of ectopic pregnancy (10 percent).

When to Choose IVF versus Tubal Reversal

IVF is a good treatment for couples who have unexplained infertility, severe sperm disorders and for women with severely damaged fallopian tubes from pelvic inflammatory disease (PID).

Tubal ligation reversal is a better treatment for women who have previously had a tubal ligation and who do not have any of the above indications for IVF.

Ligation Reversal Misinformation

Misinformation regarding tubal ligation reversal exists on the Internet. Most of this misinformation centers on the success of ligation reversal when compared to IVF, the cost and the risks of the surgical procedure.

Success Rates

The success rates of ligation reversal are related to the type of sterilization procedure a patient has undergone. At Chapel Hill Tubal Reversal Center, 69 percent of patients become pregnant after reversal of ligation and resection sterilizations. Clip and band sterilization procedures have excellent reversal results with 76 percent of patients becoming pregnant.

For IVF the success rates depend on the reason for infertility and can range from 10 to 50 percent. The average success of a single cycle is approximately 30 percent. The success rates of IVF decrease with maternal age over 35 years of age. After 40 to 42 years of age, IVF specialists will advise the use of donor eggs (eggs from another woman) to increase the chances of success. Many IVF specialists will attempt to increase the pregnancy rate of IVF by transferring several embryos into the uterus. This increases the chance of multiple gestations. Sometimes high order multiple gestations (triplets or more) will occur and these pregnancies can be very high-risk pregnancies.

Tubal ligation reversal has a higher chance of success when compared to a cycle of IVF by providing the couple with multiple opportunities to become pregnant and the ability to have more than one pregnancy without the need for hormonal control of the cycle.

Chapel Hill Tubal Reversal Center has success rates that are better than the 30 percent average success rates associated with an individual cycle of IVF.

Cost

Many sources quote tubal ligation reversal as high as $25,000. This is true if reversal ligation surgery is done in a hospital-based ambulatory care center or a hospital with an overnight stay. If a patient has a laparoscopic tubal ligation reversal or robotic assisted tubal ligation reversal, then they will pay much higher costs for surgery.

When performed as an outpatient procedure through a small abdominal incision and using microsurgical technique, ligation reversal surgery can be very affordable. Many patients are mislead to believe modern technology results in better success of ligation reversal; however, current medical literature does not support increased success rates for tubal ligation reversal when these surgeries are done laparoscopically or with robotic assistance. Success rates are similar with the use of these modern technologies when compared with abdominal incisions and microsurgical operative techniques. What is very clear is the use of these modern technologies dramatically increase the cost of reversal surgery.

The medical director of Chapel Hill Tubal Reversal Center, Dr. Gary Berger, has perfected a mini-laparotomy approach (mini-abdominal incision). He has continually refined this technique over the last twenty years. It allows easy access to the fallopian tubes and a quick operation. This minimizes the amount of time a patient spends under anesthesia. The decreased anesthetic time results in faster postoperative recovery and reduces the cost and risk of being under an anesthetic. Many hospitals charge patients for anesthesia by the minute and the longer a surgery, the higher the cost. This is true even if the surgery is done in a hospital ambulatory care center. The longer a patient is exposed to anesthesia, the more difficult and longer it takes to recover from the medication effects.

Chapel Hill Tubal Reversal Center is a free standing health care facility that is licensed by the State of North Carolina as a surgical center and has been accredited by the Joint Commission on Hospital Accreditation. Our free standing center is dedicated only to ligation reversal. We do not have to charge for anesthesia by the minute to help subsidize the services of other patients. To help patients who have ligation reversal at our center have a good postoperative period, patients stay at a local hotel and are seen the day after surgery by one of our tubal reversal nurses. Mini-laparotomy surgery is extremely safe with minimal postoperative discomfort and therefore, does not require an unnecessary, overnight hospital stay. A hotel stay is far cheaper than a hospital admission. As a result, we are able to offer ligation reversal for $5,900.

Risk of Tubal Reversal Surgery

Tubal reversal surgery is extremely safe in the appropriate patient. Patients who are not morbidly obese and who do not have severe heart, lung or vascular disease are excellent candidates for outpatient reversal surgery. There is a 10 percent risk of ectopic surgery after ligation reversal; however, with close follow-up of an early pregnancy, this risk can be appropriately managed to avoid the complication of tubal rupture.

We have had excellent operative results with few adverse outcomes in our reversal patients. We advise close follow-up care of our patients. Most suspected ectopic pregnancies are diagnosed early and treated with medical management to prevent complications.

Our Goal

At Chapel Hill Tubal Reversal Center, we are tubal ligation reversal experts dedicated to providing safe and low cost tubal ligation reversal. By keeping the cost low and focusing only on tubal ligation reversal, we make reversing a tubal ligation available to women who would be unable to afford the high cost of in-vitro fertilization or tubal reversal in the hospital setting.