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
Deanna
You should be an excellent candidate for tubal reversal. I will email you information and you are welcome to fax or email your reports to us for a review and we can let you know if you would be a candidate for reversing surgery.
Hello,
I had my tubes tied in 2007 with the filshie clips. I have gotten married since then and would like to have another child with my husband. I’m a healthy 32 yr old and have had two healthy sons. I am so worried that I won’t be able to have another child. Could I send my medical reports over to see if the surgery would be possible?
Katie
We can certainly remove your remaining tubal clip and the cost would be $5900.
I had my tubes tied after my 4th baby. 6 months after having them filshie clipped I became pregnant with my 5th child. When I found out I was pregnant I was having pain in my right tube. They did an ultra sound and saw a mass in my tube so I opted to have that tube removed. They did a biopsy and it was just a group of cysts. So now I have a 6 month old baby. My question is I just need 1 clip removed the other one was already removed. I don’t wish to have anymore babies my left tube is already opened and the reason why I became pregnant. I am not looking for a reversal I think I might possibly be allergic to the clip itself so I just want it removed. How much does something like that cost?
Traci
It is difficult to say what the cause of your symptoms are from but tubal clips do not have nickel in them. You can certainly come to our center for clip removal and or reversal and trust we will not do any additional damage to your tubes.
In 2010 I had clips put on my tubes (against my request since i had a known nickel allergy) during my third c section. For the past two years I’ve had many horrible symptoms. The worst being very heavy, painful, irregular periods. I also have rashes, heart palpitations, acne, fatigue, weight gain, pain all over, swelling, strange discharge, I could go on. I finally learned that I have the clips in me and switched doctors. My new dr says I should have the clips removed because I am allergic to them and possibly a partial hysterectomy due to the heavy bleeding and other hormonal symptoms that are not related to the clip allergy. He says a reversal will not take care of my symptoms that are not related to my allergy to the clips. However, I know that after he removes my clips he will also remove more of my tubes and make it even more difficult for me to have a reversal if I’m still having symptoms. I do not want to have more children but I also do not want anymore pain. Can you please give your advice? Can all my symptoms be caused by the clips or is it because of the tubal as well? Thank you.
Mrs Mosby
Clip reversal cost $5900 and it is the same price as tubal reversal because simply removing the clips will not allow you to become pregnant. The clips must be removed and the closed ends opened and then rejoined with the same technique used during reversal of a standard tubal ligation.