Tubal Reversal Blog ‘tubal occlusion’

Tubal Sterilization Methods

‘Tying tubes’ is a phrase that is commonly used to refer to surgical procedures that result in tubal sterilization.

There are many different ways to block the fallopian tubes for tubal sterilization: ligation and resection (tying and cutting), tubal clips or rings, and electrocoagulation (burning). No matter how the procedure is done, the end result is closure or occlusion of the fallopian tube. This prevents sperm from reaching an egg.

Tubal Ligation and Resection

The most common female sterilization procedure is the ligation and resection method. This was the earliest reported method of sterilization, and it is still a very common and effective procedure. According to the method described by Dr. Ralph Pomeroy, an absorbable suture is tied around a “knuckle” of the fallopian tube that has been elevated and a segment is resected (cut out). The cut ends close as the tube heals. As the suture dissolves, the two tubal segments pull apart. Ligation and resection is currently the most popular form of sterilization for women. It is often performed during a cesarean delivery (C-section) or following a normal delivery.

Untying ‘Tied’ Tubes

A common misconception is that fertility can be restored by simply ‘untying’ the tubes. Tubal ligation reversal is not that simple. Tubal ligation and resection is reversed by opening the closed ends of the tubes and joining the tubal segments back together in perfect alignment using microsurgical techniques. Approximately 70% of patients at Chapel Hill Tubal Reversal Center become pregnant after a reversal of a ligation and resection procedure.

Tubal Ligation and Resection Can Be Reversed

Many people believe tubal sterilization is permanent and irreversible. Although tubal ligation and resection sterilization is intended to be permanent, this procedure can be reversed. Chapel Hill Tubal Reversal Center is the medical facility that specializes in tubal ligation reversal. We are experts in reversing tubal ligations- or ‘untying’ tubes that have been ‘tied’!

Submitted by Dr. Charles Monteith

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