Tubal Reversal Blog June 17th, 2008

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.