Difficult Tubal Reversal Situations
How Important Is a Tubal Reversal Doctor’s Experience?
Of the many questions I receive daily from potential patients, one of the most important questions is what makes Dr. Berger the best choice to perform tubal reversal vs. another doctor. With a specialized procedure such as tubal ligation reversal, surgical experience is the most important factor in predicting success from the operation. Dr. Berger has performed more than 7000 tubal reversal operations and has the most experience of any tubal surgeon in the world.
Tubal Repairs That Other Doctors Could Not Perform
We routinely hear from women who have gone to a nearby doctor for a tubal reversal, only to have the doctor stop the procedure before repairing the tubes because an unexpected situation was encountered during surgery. There are multiple situations where this may happen:
1. No isthmic tubal segment remains and tubouterine implantation needs to be performed.
There are few, if any, other doctors who can perform this type of operation and none could do so as outpatient surgery. At Chapel Hill Tubal Reversal Center, Dr. Berger has successfully performed this type of operation many times as a safe and effective outpatient operation.
2. A fimbriectomy has been performed.
Tubal ligation by fimbriectomy involves removing a portion (usually up to one-third) of the fallopian tube closest to the ovary. To our knowledge there are no other doctors performing fimbriectomy reversals. The pregnancy rate following fimbriectomy reversal performed by Dr. Berger is 56%.
3. The patient has only a proximal tubal segment (attached to the uterus) on one side and a distal tubal segment (near the ovary) on the other side.
This is an unusual situation, but Dr. Berger has successfully attached these two segments on opposite sides of the body to create one tube with 2/3 women becoming pregnant afterwards. This operation has not been described in the medical literature. Dr. Berger calls this operation “contralateral tubotubal anastomosis”.
4. The patient is found at the time of surgery to have inherent disease of the fallopian tubes due to tubal endometriosis, salpingitis isthmica nodosa, or pelvic inflammatory disease. In these situations, Dr. Berger removes the diseased tubal segment and repairs the fallopian tube with the most appropriate reversal operation.
Experience Is The Most Important Consideration
Experience is the most important indicator of whether successful tubal reversal surgery can be performed when a woman has a difficult tubal reversal situation due to short tubes, missing tubal segments, fimbriectomy, or inherent diseases of the tubes. While most doctors would be unwilling – or unable - to perform a reversal procedure in one of these situations, Dr. Gary Berger is able to repair the tubes in 98% of cases, regardless of the type of sterilization that has been performed or whether difficult situations are encountered.
Submitted by Julia Smith, R.N.
Nurse Administrator
If you have questions or would like assistance scheduling your surgery, please contact me.
JuliaS@tubal-reversal.net
(919) 656-8204
May 20th, 2008 at 7:57 pm
I think that experience is the most important factor in chosing a surgeon to perform tubal reversal surgery. Dr. Berger’s dedication to tubal reversal surgery and patient care is evident in the outcomes of the surgeries that he performs.
May 21st, 2008 at 6:22 am
Yes, experience is the key to success! Dr. Berger has more experience and has performed more tubal anastomosis procedures than any other doctor. As a surgical technician, I can attest to the critical importance of the surgeon’s experience in how an operation proceeds and the patient’s outcome from it.
May 21st, 2008 at 6:22 am
If I were choosing between doctors for a specialized surgery I would definitely put the doctor’s experience at the top of my priority list. As an OR nurse, I know just how important a factor this is. Experience plays a huge role in the outcomes of the surgery.
May 21st, 2008 at 7:40 am
Dr. Berger’s experience and confidence in performing tubal reversal in different and difficult situations is what makes him such a great surgeon. These factors are two of the primary reasons why women choose to come to Chapel Hill for their tubal reversal procedures.
May 21st, 2008 at 10:35 am
Dr. Monteith is very lucky to be learning tubal reversal surgery from Dr. Berger as he will benefit greatly from his vast experience. Dr. Berger is training Dr. Monteith to perform all the different types of procedures used to repair all different types of ligations.
May 21st, 2008 at 11:14 am
I believe that the more experience the surgeon has, the better the end result will be. Having performed as many reversals as Dr. Berger has, chances are, he’s “seen it all”. His compassion and dedication for his practice and procedure are to be admired.
May 21st, 2008 at 12:00 pm
When we see these difficult situations in the operating room, I watch with fascination as Dr Berger reconstructs the fallopian tube, even in the most difficult of circumstances. He truly believes in giving each and every patint the hope of realizing their dream. This level of skill and experience is one of the many reasons Dr Monteith will benefit from working side by side with Dr Berger.
May 21st, 2008 at 12:20 pm
In doing as many of these surgeries as Dr. Berger has, these unusual situations become another part of a day’s work. It’s not only the experience of Dr. Berger. but also the experience of his staff that work closely along side him as well. Everyone here is experienced in this outpatient specialty giving the patient comfort in any situation.
May 21st, 2008 at 1:55 pm
Working for Dr. Berger, as a surgical technician, I’m always impressed that the tubal reversal procedure is not the same from one patient to the next. Depending on the patient’s type of tubal ligation and condition of the remaining tube after ligation, the repair can be so varied. After performing more than 7000 tubal reversals, I understand why it is so important to note that the experience Dr. Berger has makes all the difference in the success of his tubal reversal surgeries.
May 22nd, 2008 at 8:02 am
This is excellent information from Julia describing well the types of unusual situations that can occur following tubal ligation. This is precisely why Dr. Berger’s experience is so valuable to women needing tubal reversal. Once you are in the OR it is too late to “call someone else.”
May 22nd, 2008 at 6:37 pm
I have been impressed how Dr. Berger will try every option available to him to repair the fallopian tubes. Where less experienced doctors may give up and say the tube is unrepairable, Dr. Berger always takes the extra time and goes the extra mile to give his patients a successful outcome if at all possible.