Will Tubal Reversal Become a Lost Skill?
Tubal reversal surgery is becoming a lost skill among doctors in training, according to an article in the January 2008 issue of Fertility and Sterility, the most influential medical journal for reproductive specialists. The article states, “The future for tubal anastomosis seems grim…and, like the Roman Empire, may be lost in Antiquity.”
The thesis of the article was that almost exclusive concentration on IVF and related reproductive technologies has decreased the training of reproductive specialists in tubal reparative surgery.
“The success of surgical tubal anastomosis is directly linked to surgical experience. With the advent of ART, surgical training has markedly declined, and there remain few fellowship programs with meaningful numbers of surgical cases. One study reported that most of the current Reproductive Endocrinology and Infertility fellows performed less than 10 procedures and 35% of program graduates performed no surgical tubal reversals in the previous year.”
Chapel Hill Tubal Reversal Center is for Patient Care
Patients have occasionally asked me if, with the experience I have had performing tubal reversals, I was teaching other physicians to perform this kind of surgery. Since Chapel Hill Tubal Reversal Center is a private practice dedicated to patient care - not a training institution - I have not previously taught other physicians the skills acquired over the 30 years I have been practicing as a reproductive surgeon. Having residents or RE fellows coming here for brief periods would allow only an introduction to the techniques of tubal reparative surgery. This would be insufficient for them to acquire all of the skills necessary to perform tubal reversals.
Introducing Dr. Charles Monteith
Recently, Dr. Charles Monteith, an Assistant Professor of Obstetrics and Gynecology at the UNC School of Medicine, requested a mentoring relationship with me to learn the techniques of tubal reversal surgery. Dr. Monteith is a board certified obstetrician-gynecologist with 6 years of surgical experience subsequent to completing his residency at the UCSF Medical Center. He has begun assisting me in surgery and will continue to do so on selected dates during the next 6 months. Some of the patients who have come here since January 1st have already met him. With his prior surgical experience, and after an extended training period, Dr. Monteith will become certified as a Tubal Reversal Specialist and join our staff in July 2008.
Dr. Berger’s Comment
My response, therefore, to the Fertility and Sterility article is that tubal anastomosis will not become “lost in Antiquity”. Perhaps in the future, other physicians will follow the path that Dr. Monteith has chosen to learn the skills and techniques required for successful tubal reversal operations. More information about Dr. Monteith will be available in forthcoming blog posts and on the Chapel Hill Tubal Reversal Center website.
January 20th, 2008 at 11:25 am
I, for one, am happy to learn that Dr. Berger is sharing his extensive experience with another doctor who is joining his practice. There are too many of us in waiting to have his skills lost in the future. Congratulations to Dr. Berger and Dr. Monteith and to all of the women who will benefit from this.
January 20th, 2008 at 1:06 pm
Everyone at Chapel Hill Tubal Reversal Center and Chapel Hill Surgical Center is very excited about having Dr. Monteith with us. We are especially happy to have a doctor joining Dr. Berger who brings a similar desire for excellent patient care and customer service.
January 20th, 2008 at 1:18 pm
Dr. Monteith will definitely learn about tubal reversal surgery from the best! It will be a pleasure to have him join the practice and gain the experience necessary to provide the care that our patients deserve.
January 20th, 2008 at 1:42 pm
Welcome Dr. Monteith! We are so excited that Dr. Berger is able to share and teach his specialized technique for tubal reversal surgery to another great doctor. We look forward to working with Dr. Monteith for years to come!
January 20th, 2008 at 3:47 pm
I am excited that Dr. Monteith is joining Dr. Berger. He is definately learning from the best. This i yet another example of Dr. Berger’s dedication to tubal reversal surgery. This truely shows his desire to help couples everywhere to hopefully fullfill their dreams of having a child together.
January 20th, 2008 at 9:18 pm
I have enjoyed working with Dr. Montieth so far! We are all excited to have him on staff. He is eagar to learn the specialized techniques that Dr. Berger uses to make tubal reversal surgery so successful.
January 20th, 2008 at 10:53 pm
Thankfully Dr. Berger is willing to share his skills in tubal ligation reversal with Dr. Monteith at the Chapel Hill Surgical Center. Many will benefit from this partnership and training.
January 21st, 2008 at 7:58 am
Welcome, Dr. Monteith! It is exciting to know that Dr. Berger’s experience will be shared.
January 21st, 2008 at 8:22 am
Welcome Dr. Monteith, it is a pleasure to know that Dr.Berger and Dr. Monteith will continue to help couples everywhere that still want to have children.
January 21st, 2008 at 10:12 am
I am very excited to learn that Dr Monteith will be joining the Tubal Reversal Center/Surgical Center staff.
I have personally work with Dr Monteith in other surgical settings and he receives nothing but praise and respect from fellow surgeons and the entire medical staff.
Welcome Dr Monteith!
January 21st, 2008 at 12:58 pm
It is good to know that Dr. Monteith shares Dr. Berger’s committment to excellence in women’s health care and tubal reversal surgery. Having him join Dr. Berger will afford even more women the opportunity to have this highly specialized procedure in a world class facility.
January 22nd, 2008 at 8:54 am
I think it is great that Dr. Monteith will be joining the Surgical Center/Tubal Reversal Center staff!
January 24th, 2008 at 2:29 pm
Dr. Berger and Dr. Monteith are dedicated to women’s health and fertility. It is reassuring to women who desire pregnancy after a tubal ligation that the practice of tubal reversal surgery will not be lost. Dr. Berger is extending his expertise to Dr. Monteith to enable these women the opportunity to conceive again. I have enjoyed working with Dr. Monteith.
January 25th, 2008 at 10:34 pm
Dr. Berger, I didn’t say anything before surgery (I had my TR on Jan 17th 08′)but I am about to apply to Med School (2009-2010) and this is what I want to do with the rest of my life. So in about 10 years or so, I will be keeping the knowledge alive. This is of course “IF” I can get “accepted” into Med School. I am in a shadowing program at my local hospital and my GPA is 3.95 I have not yet taken my MCATs, it will be more than a year before I’m fully ready but I am studing. Thanks again for being a fine example of a excellent healer.
Gwen Brancato
January 26th, 2008 at 3:42 pm
Thank you for your comment, Gwen. With your excellent GPA, it looks like you shouldn’t have problems getting into Medical school. Keep me informed about this!!