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.

New patients may want to learn about the relationship between Chapel Hill Tubal Reversal Center and Chapel Hill Surgical Center. They are interrelated health care organizations exclusively for the benefit of patients undergoing tubal reversal surgery.

Chapel Hill Tubal Reversal Center

Chapel Hill Tubal Reversal Center is the name of my private practice. It is located on the second floor of a 2 story building at 109 Conner Drive in Chapel Hill, North Carolina. Prior to 1997, Chapel Hill Tubal Reversal Center was known as Chapel Hill Fertility Center. During earlier years, complete diagnostic and treatment services were provided for all causes of infertility. Because it has always been my primary interest and special skill, I decided to limit my practice to tubal reparative surgery. I am the the only reproductive surgeon who performs tubal reversal surgery exclusively.

Chapel Hill Surgical Center

Chapel Hill Surgical Center is a licensed ambulatory surgical facility that occupies the first floor of 109 Conner Drive in Chapel Hill. This is where the tubal reversal procedures are performed. The facility has 3 operating rooms, a two-stage recovery room, and is staffed by a team of anesthesiologists, a nurse anesthetist, operating room nurses, recovery room nurses, surgical technologists, and an administrative staff. In the past, it was operated as a general ambulatory surgical center that included other doctors from many other surgical specialties. The facility was reorganized to provide tubal reconstructive surgery alone to allow all of the professional staff to concentrate on tubal reversal patients. This has led to the best medical care for women having a tubal reversal procedure.

A Unique Medical Organization

As the Medical Director of both facilities, I am assisted by a dedicated and highly trained staff of over 20 people who devote all of their efforts to caring for 4 couples a day having tubal reversal surgery. The staff to patient ratio (5:1) is higher than found in any other surgical center or hospital. This permits the most attentive and personalized medical care possible. There is no other medical organization like this anywhere else. Most patients learn about us from the Chapel Hill Tubal Reversal Center website, while others are referred by their doctors or previous patients. Couples come here from all 50 states in the US and from every continent around the world.

Our Mission

We take pride in being the premier medical facility for tubal ligation reversal. Our mission for 2008 is to restore hope, fertility, and the opportunity to have children for 800 more couples, as we have done each year in the past.