Chapel Hill Tubal Reversal Center 109 Conner Drive Suite 2200, Chapel Hill, NC 27514 (919) 968-4656
Tubal Reversal Surgery Checklist
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Chapel Hill Tubal Reversal Center
This checklist will help ensure your successful preparation for and recovery after your tubal reversal by Dr. Berger or Dr. Monteith. Use the Printer page to print it, and mark off each item on the timeline as you complete this checklist.
When surgery date is scheduled:
| ___ | Within 24 hours of scheduling, return a signed and dated copy of the New Patient Confirmation letter, the Patient Requirements and Responsibilities Statement, and the completed Registration Packet to our office by fax (# 919-869-1976) or by scanning and emailing documents back to the person who emailed you the paperwork. |
| ___ | Pre-op lab results are due in our office no later than 3 weeks prior to the surgery date. Testing should be performed within a day or two of scheduling surgery, but not more than 90 days prior to the surgery date. |
| ___ | CBC |
| ___ | HIV-1 antibody |
| ___ | Hepatitis B Surface Antigen |
| ___ | Hepatitis C Antibody |
| ___ | (Additional pre-operative testing will be required for patients with history of medical problems.) If you have questions about your pre-op lab test results, contact us at (919) 968-4656. |
| ___ | Make reservations at the Residence Inn Chapel Hill (make sure you are quoted the special rate for Chapel Hill Tubal Reversal Center patients). |
3 weeks prior to surgery: | |
| ___ | Avoid anti-inflammatory medications such as aspirin, ibuprofen (Advil, Nuprin, Motrin), and naproxen (Naprosyn, Aleve). Acetaminophen (Tylenol) is an acceptable over-the-counter pain medication during the 3 weeks preceding your surgery. |
| ___ | Avoid herbal supplements, green tea, and diet pills. |
| ___ | If you have not been contacted for your pre-anesthesia telephone consultation, call (919) 968-0611 between 12 noon and 2 pm Eastern Time and ask for the anesthesia staff. |
3 days prior to surgery: | |
| ___ | Start daily washing of abdomen with HIBICLENS® soap. |
| ___ | Remove finger nail polish and any type of artificial finger nails. |
When you leave for Chapel Hill: | |
| ___ | Bring (or pick up when in Chapel Hill) the following - Loose clothing, warm socks, bottle of Ibuprofen (Advil, Nuprin, Motrin), thermometer, and non-carbonated clear liquids for after surgery (such as tea, water, apple juice, white grape juice, lemonade without pulp) and jello. A small pillow to use for bracing the incision or as padding during car travel. |
Day prior to surgery: | |
| ___ | Come to Chapel Hill Tubal Reversal Center for your pre-op consultation (includes vaginal ultrasound exam). |
| ___ | Eat a light dinner such as soup and ½ sandwich. Avoid fried or fatty foods. |
| ___ | Take Zantac 150 mg at bedtime. |
| ___ | Do not eat anything after 10:00 pm. Small amounts of clear liquids are acceptable until 2 hours before arrival time for surgery. |
Day of surgery: | |
| ___ | Shower using HIBICLENS® soap |
| ___ | Take Zantac 150 mg with sip of water 1 hour before arriving at the surgical center. |
| ___ | Do not eat breakfast. |
| ___ | Do not wear make-up, perfume, jewelry (including body piercings), or contact lenses. |
| ___ | Arrive at Chapel Hill Surgical Center at designated time with 1 responsible adult and no children. |
Day after surgery: | |
| ___ | Shower leaving the Tegaderm dressing on (the Chapel Hill Tubal Reversal Center nurse will change the dressing for you during your post operative nurse visit). |
| ___ | Check temperature morning and evening for 1 week - call us if above 100.0 F. |
5 days after surgery: | |
| ___ | Remove steri-strips. |
10 days after surgery: | |
| ___ | Clip suture knots at skin level. |
When you have a positive pregnancy test: | |
| ___ | Read the I'm Pregnant page on our website. |
| ___ | Complete the on-line Pregnancy Report Form, or call a tubal reversal nurse at (919) 968-4656. |
| ___ | Have quantitative serum HCG assays twice a week through your ob/gyn doctor. |
| ___ | Schedule vaginal ultrasound exam when HCG is between 1500-2500 for gestation sac location. |
| ___ | Keep us informed of your results! |
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Website updated February 4th, 2012 
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109 Conner Drive Suite 2200, Chapel Hill, NC 27514 (919) 968-4656
http://www.tubal-reversal.net/tubal-reversal-surgery-checklist.htm was last modified on May 11th, 2011 19:49:24
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