Untying Tied Tubes: Filshie Clip Sterilization
Tying Tubes is Not Like Tying a Shoe Lace
Many patients seem to imagine the fallopian tube is like a shoe lace which is tied up like a bow to prevent pregnancy. As tubal ligation reversal specialists, we wish it were that easy- then untying tied tubes would be easier!
‘Tying fallopian tubes’ is a common language phrase used to describe several different surgical procedures that result in tubal sterilization (a procedure intended to permanently prevent pregnancy). The more correct medical term is bilateral (both sides) tubal occlusion (closure of the fallopian tube).
Tubal Ligation Methods
There are many different ways to occlude (close) the fallopian tubes: ligation and resection (tying and cutting), clips and rings, and coagulation (burning). No matter how the procedure is done the end result causes the tube to close, heal shut, and prevent sperm from fertilizing an egg.
Filshie Clip Tubal Ligation
One common form of laparoscopic (camera) sterilization is the use of Filshie clips to occlude both fallopian tubes. The Filshie clip was approved for use in the United States in the mid 1990’s. The Filshie clip is a small titanium clip which is lined with a thin silicone cushion. The clip was an improvement over the Yoon Falope Ring and the Hulka Clip because it was as easy to apply with less risk of operative complications. The clip also has the advantage of destroying only a very small portion of the fallopian tube- approximately 4mm (approximately the thickness of two quarters stacked on each other). The adjacent tube is not affected. The majority of Filshie clips placed in the United States are done by laparoscopic surgery; however, there is a growing trend to use them for tubal occlusion at the time of cesarean delivery (c-section).
The Filshie clip causes bilateral tubal occlusion by squeezing a very small portion of the tube. The squeezed portion is deprived of its blood supply and eventually undergoes avascular necrosis (dies and is absorbed by the body). This causes the fallopian tube to be divided in half and the two ends to close up. The Filshie clip is held in place (in between the two divided ends) by a small amount of scar tissue which forms over the clip.
A common misconception is that the Filshie clips can simply be removed to reverse the sterilization process- that the tubes can be unclipped. Unfortunately, tubal ligation reversal for Filshie clips is not as simple as just opening the clips. Filshie clip tubal occlusion is reversed by removing the clips and using microsurgical techniques to open the closed ends and join the tubal segments back together in perfect alignment.
The reversal of Filshie clip tubal occlusion is usually technically easier than some other methods of sterilization because such a minimal amount of tube is destroyed in the occlusion process.
Approximately 76% of patients at Chapel Hill Tubal Reversal Center become pregnant after a reversal of a Filshie clip sterilization procedure.
Tubal Sterilization Can Be Reversed
Many people believe tubal sterilization is permanent and irreversible. Although Filshie clip sterilization is intended to be permanent, this procedure can be reversed. Chapel Hill Tubal Reversal Center is the one medical facility that specializes in tubal ligation reversal.
We have become experts in reversing all types of tubal ligations- or ‘untying’ tubes that have been ‘tied’!
Submitted by Dr. Charles Monteith






January 25th, 2010 at 10:16 pm
Amanda
The Hulka or Filshie tubal clips are designed to be a part of your body. Only very rarely have they been associated with severe complications. I would only make the decision to have it removed after carefully talking with your doctor and only if they are causing you any suspected problems or complications.
January 25th, 2010 at 8:54 pm
I had a tubal ligation done with the tubal clips and they were giving me problems. Finally after 4 years of complaining they went in and found out that the clips were giving me problems the only thing was that the clip on my right side wasn’t on my tube. They couldn’t find it after 45 minutes of looking. It was found later in an x ray near my spleen. Should I be concerned about it just floating around in there?
January 22nd, 2010 at 7:53 am
JULIE – Tubal clips will not come undone on their own. They do not expire. It would be a good idea for you to see your doctor regarding the pain that you are having.
January 21st, 2010 at 9:53 pm
Can tubal clips become unclipped? I had both tubes clipped in 2001 and the dr. said he put 2 clips on each tube. Do they expire? For the past week I have been having some awkward feelings in my pelvic area like there is something moving in there or bubbles continuously popping. It is sometimes painful and VERY uncomfortable.
January 9th, 2010 at 10:00 am
Amanda
Take a pregnancy test. If it is positive you should be seen in the ER to make sure you do not have an ectopic (tubal) pregnancy. If it is negative then make an appointment with your doctor to discuss your irregular periods and to check for hormonal imbalances.
January 9th, 2010 at 9:04 am
I had the tubal clips put on January of 2009 and I was wondering is it possible to become pregnant if they were not put on right or have moved? It’s now January 2010 and i haven’t had a period in almost 2 months I was just wondering what the chances of that would be?
December 7th, 2009 at 2:33 pm
NJ
Even with one tube you would have a good chance of becoming pregnant. The reversal of the tubal clip yields the highest pregnancy success rates. We have many patients who become pregnant with only one fallopian tube.
December 7th, 2009 at 1:37 am
I have only one tube due to an unfortunate injury just over a year ago. At the time of the operation to remove the damaged right tube and ovary the doctor placed filshie clip on the left tube. I regret my sterilization and want to get pregnant. What are my chances of getting pregnant if I had this reversed with only one tube and one ovary? What is the cost and healing time? I read the comments about pain and wanted to tell those thinking about the clip ligation that I have had pain ever since I had it put on my one tube.
December 3rd, 2009 at 4:54 pm
MAANITA – If you want to become pregnant after tubal burning, the you will need treatment by either tubal ligation reversal or IVF.
December 3rd, 2009 at 3:54 pm
I want to know if we have a possibility to become a pregnant without reversal tubal even though my tubal burned already? My tubal was burned after I was giving birth in 2001.
November 8th, 2009 at 11:12 am
[...] c-section and delivered a healthy baby boy. At Jamie’s request, her obstetrician performed a Filshie clip tubal ligation.After Tubal Ligation Consequences: Tragedy Their quest for tubal ligation reversal began in December [...]
October 25th, 2009 at 9:36 am
I had my tubes tied 4 year ago and now there’s too much pain and I can’t stand sex. I want my sex life back . I want to have my tubes untied so I will get my back sex life again.
October 22nd, 2009 at 8:01 pm
You can read the page on Getting Started With Tubal Reversal. Call (919) 968-4656 for a telephone consultation with a Tubal Reversal Nurse.
October 22nd, 2009 at 4:49 pm
How can I have a reversal procedure? What steps do I take?
October 22nd, 2009 at 12:37 pm
Tina T
Having your tubes unclipped- or a tubal ligation reversal – would be your best choice. Insemination will not help you become pregnant because your tubes are blocked. Insemination only puts sperm into your uterus. Since your tubes are blocked the sperm will never be able to reach the egg.
IVF would allow you to have another child. IVF does have IVF risks. IVF costs between $9-12,000 and the average chance of success is 35%. Tubal reversal at Chapel Hill Tubal Reversal Center costs less and average success is 70%. You should call our office at (919)969-4656 for a free, nurse consultation.
October 22nd, 2009 at 12:24 pm
I had my tubes clipped September 2008 after a c-section with my son. I really regret this and want to reverse it to have another baby. Would it be better for me to unclipped the tubes or to be inseminated? And which way would I be most likely to have another baby? Please Help! Many Thanks.
October 5th, 2009 at 2:31 pm
I agree with the ladies that complain about pain after the procedure with the Filshie Clips. I have regretted having the tubal ligation performed and I would never recommend this as a form of birth control. I am now researching tubal ligation reversal so my happiness and well being can be restored.
September 25th, 2009 at 10:40 am
I had my clips placed on my tubes in March of 2006. I have had sharp pains also. Honestly I would not recommend anyone doing this precedure because in my opinion it causes pain. there arent alot of case studies done because alot of people dont relate the pain with the clips, but I have research it and so has my ob doctor and to make a long story short I am getting my clips removed on Oct 6 2009 due to medical complications. yes my insurance is covering the surgery. I will still be sterile because the tubes are damaged because of the clips but hopefully the pain will go away…
September 8th, 2009 at 12:42 pm
Edw
There have been reports of clip migration and pain after clip placement. This is thought to be uncommon.
September 8th, 2009 at 12:07 pm
Are there cases know that the body rejects the Filshie clips and is this possible?
August 22nd, 2009 at 10:55 am
Filshie clip application gives immediate protection, unlike vasectomy. However, if it was performed shortly after ovulation, the cycle in which it was performed could result in pregnancy.
August 22nd, 2009 at 9:13 am
How long after having Filshie clip sterilization can I have sex without using protection with my husband? I know after a vasectomy it takes a while but I’m unsure about female sterilization…thanks.
August 19th, 2009 at 7:12 pm
Tubal ligation is permanent unless you get them reversed. They do not come untied unless a surgeon performs the reversal procedure.
August 19th, 2009 at 12:37 pm
How long do your tubes stay tied up? I got them tied in1997!
July 26th, 2009 at 8:27 pm
My name is Bridget Clinard and I want to know about getting tubal ligation reversal so I can become pregnant again. I am deaf but I do not have any other health problems. I want to get this done so I can become pregnant again. Please email me at crazylovebri@tmail.com or you can call me directly at 866 758 0605 and ask for Bridget. Many thanks! Bridget.
July 19th, 2009 at 8:37 pm
Read this information about tubal reversal cost or watch a video that discusses the cost of tubal ligation reversal. You will get the best tubal reversal surgery at Chapel Hill Tubal Reversal Center. If you have any questions, call (919) 968-4656 for a telephone consultation with a Tubal Reversal Nurse.
July 19th, 2009 at 8:34 pm
Read this page about Tubal Reversal Cost, or watch the video about cost of tubal ligation reversal. If you have any questions, call (919) 968-4656 for a consultation with a Tubal Reversal Nurse. You will get the best tubal reversal surgery for the lowest cost at Chapel Hill Tubal Reversal Center.
July 19th, 2009 at 5:33 pm
How much would it be to have tubal reversed?
April 8th, 2009 at 4:21 pm
There have been rare reports of pain after clip placement. Typically the clips are designed to be with you for the rest of the life and they are not commonly thought to be a cause of pain.
April 8th, 2009 at 2:31 pm
Can these clips be a cause of pain in years to come? I had mine placed in 2002 and since then notice pain (sharp) in the area I imagine them to be placed.
November 21st, 2008 at 2:50 pm
This is helpful for those women who decide to have kids again, and are looking for information regarding Filshie clips.
October 15th, 2008 at 4:10 pm
Yes, clips are the best of all tubal ligation procedures for reversal. Look at Table 4 on our website page that shows pregnancy rates after tubal ligation reversal by method of tubal ligation and you will see that it has a 76% pregnancy rate for women of all ages, ranging up to 87% for women less than 30 years of age.
October 15th, 2008 at 12:40 pm
can you still become pregant if you had your tubes clipped
June 4th, 2008 at 6:42 am
Thank you, Dr. Monteith, for helping women feel they can discuss the choices of sterilization with their doctors in the event that tubal reversal could be a possibility for them in the future.
May 19th, 2008 at 11:45 am
This is good news for those women who have had filshie clips and now desire tubal reversal surgery.
May 15th, 2008 at 10:32 am
Thank you Dr. Monteith. Women who have Filshie clips can now better understand the process of removing the clips during tubal reversal.
May 12th, 2008 at 2:18 pm
I really like the Filshie clips as well as the Hulka clips because they are less harmful to the tubes and are normal\ly easier to reverse than other procedures.
May 12th, 2008 at 1:23 pm
For patients who are looking for information regarding Filshe Clips,this is excellent and encouraging data.
May 12th, 2008 at 11:51 am
This is a great in-depth and informative post about the Hulka clip. Thanks.
May 12th, 2008 at 11:40 am
In the operating room I frequently see that the Filshe Clip is found to be one of the least destructive types of tubal ligation.
May 12th, 2008 at 4:31 am
I think that this will be helpful for women who have had the Filshie clip method of sterilization. This will help them understand that the clip can not just be removed to open the tube. Providing this type of information goes to show the dedication to patient care that the staff at Chapel Hill Tubal Reversal Center has. Thank you for placing patients first.
May 11th, 2008 at 2:22 pm
Thank you Dr. Monteith for the very informative blog about Filshie clip ligations. This will be a great resource to show patients who have had the Filshie clip ligation so they can understand a little better what they had done and how it can be reversed.