Untying Tied Tubes: Bipolar Electrocoagulation
History of Tubal Sterilization
The first tubal sterilization procedure, reported in 1881, was tubal ligation and resection. Ligation and resection - or ‘tying tubes’ was the most common surgery for sterilization until the advent of laparoscopic surgery in the mid 1900’s. As laparoscopic surgery became more popular, electrocoagulation (electrical burning) of the fallopian tubes became an additional method of surgical sterilization. Tubal sterilization by electrocoagulation uses electric current to cut and destroy the portion of the tube that is exposed to the electric current. These portions of the tube eventually heal and close.
Monopolar Tubal Coagulation
The initial method of laparoscopic tubal coagulation, in 1962, used a type of electrical current termed monopolar current. Monopolar tubal electrocoagulation was a popular type of laparoscopic sterilization through the 1970’s and 1980’s. The medical community began to realize that the complication rate from this form of electric surgery was higher than for other electric surgical methods of tubal sterilization. Sterilization procedures done by monopolar current have gradually been replaced with bipolar current.
Bipolar Electrocoagulation of the Fallopian Tubes
The first reported sterilization using bipolar electrocoagulation was in 1972. This was done via a laparoscope inserted just under the belly button. During bipolar coagulation, the electrical current can be more precisely controlled, resulting in less tubal damage than monopolar coagulation. This sterilization procedure results in higher reversal success rates than monopolar electrocoagulation.
Reversing Tubal Sterilization
Many people, including doctors, mistakenly believe that tubal sterilization is permanent and irreversible. Although bipolar coagulation sterilization is intended to be permanent, this procedure can be reversed successfully in almost all cases. The success rates depend on how many different areas of the tube were damaged with electrocautery. Approximately 60- 70%Â of patients at Chapel Hill Tubal Reversal Center become pregnant after a reversal of a bipolar coagulation sterilization procedure. Chapel Hill Tubal Reversal Center is the only medical facility that specializes exclusively in reversal of tubal ligation. We perform tubal ligation reversals every day, and our tubal reversal doctors are experts in reversing all types of tubal ligations- or ‘untying’ tubes that have been ‘tied’!
Submitted by Dr. Charles Monteith
May 15th, 2008 at 8:10 pm
I think that this information will give many women out there who feel that since their tubes were burned that there is no chance for reversal. The good news is that Dr. Berger is able to repair the tubes in 98% of the cases. This is great news for many women.
May 16th, 2008 at 10:29 am
Thank you for sharing the history of tubal ligation by cautery - it was interesting to learn how physicians gradually switched from monopolar to bipolar cautery, and the diagrams are helpful, as well. It is reassuring to know that Dr. Berger is able to reverse tubal ligations that have been done by all of the various methods.
May 16th, 2008 at 10:53 am
Thanks for the informative blog post! I have a lot of potential patients call and ask: “If my tubes have been burned can it still be reversed?” I explain to them that this is one of the more common types and is normally always reversible.
May 16th, 2008 at 10:55 am
This is an excellent decription of exactly what we see in the operating room during tubal reversal or untying. Just one more reason that the Chapel Hill Tubal Reversal Center is the premier place to come for this type of surgery. Despite many different methods of tying the tubes, we are able to repair them in almost every case thanks to the experience and expertise of our surgeons.
May 16th, 2008 at 1:59 pm
It’s so helpful for Dr. Berger and Dr. Monteith to provide such good information on the sterilization procedures available to help women understand the tubal reversal surgery of “untying tied tubes”. For those women desiring to have their “tubes tied”, it certainly gives women the opportunity to talk to their doctor about the type of sterilization procedure they can choose as certain ligation procedures have a higher tubal reversal pregnancy rate.
May 16th, 2008 at 2:20 pm
When a tube has been coagulated or burned it can still be reversed so that women can have more children. We reverse this type of tubal ligation almost every day!
May 18th, 2008 at 6:35 pm
Thanks to Dr. Monteith for this helpful information regarding tubal ligation. Many women are searching to understand their ligation and to find data regarding tubal reversal. This is a great service for educating women whose tubes have been burned about the possibilities of being able to become pregnant again.
May 19th, 2008 at 6:48 am
Thanks Dr. Montieth this is great information for people to know. Tubes are sometimes burned but we can still repair them and most still become pregnant.
September 14th, 2008 at 10:49 pm
How much does it cost to have your tubes untied?
September 15th, 2008 at 3:03 am
Crystal - Click on the “Cost” navigation bar at the top left of the page.
September 15th, 2008 at 5:46 am
Hello Crystal,
The total fee (as of September 2008) for tubal ligation reversal surgery by Dr. Berger is $5900 when payment is made in full within 24 hours after scheduling your surgery.
Chapel Hill Tubal Reversal Center offers two fee options:
1) The standard tubal reversal fee is $6,900. With the standard fee, you can schedule your appointment and hold a date with a $250 down payment.
2) The reduced tubal reversal cost is $5,900 ($1,000 discount) and is due in full at the time of scheduling your surgery.
In other words, if you called today to schedule a surgery 2 months from now, to obtain the reduced fee a payment of $5,900 will be required by tomorrow, if scheduling the standard fee ($6,900) payment will be due in five weeks, or three weeks before your TR.
The fees for tubal reversal procedures are all-inclusive and cover:
* Preoperative record review and consultation
* Surgeon’s fee
* Anesthesia fees
* Surgical supplies
* Operating facility fees
* Postoperative pain medication
* Follow-up care.
Some insurance companies may cover part of the cost of tubal ligation reversal. We are a fee for service practice and do not accept payments from insurance carriers. The insurance code (ICD-9) for bilateral tubal occlusion is 628.2. The procedure code (CPT) for tubotubal anastomosis is 58750.
Chapel Hill Tubal Reversal Center offers the option of a screening diagnostic laparoscopy prior to tubal reversal surgery. There is an additional charge of $1000 to add the screening laparoscopy, but with this option close to 50% of the total fee is refunded should tubal repair not be possible.
Crystal if you have questions regarding costs or payment options, please contact us (919) 968-4656.
More information on the cost of reversing tied tubes