Tied And Cut Tubes: Tying Tubes Explained
Ligation means to ‘tie’ and resection means to ‘cut’. Ligation and resection is by far the most common way to perform a tubal ligation procedure.
Many people mistakenly believe when a tube is tied with a suture that if the suture comes undone or if the suture is removed then the tube will be normal and natural pregnancy can happen. Unfortunately this is incorrect and reversing tied and cut tubes is not as simple as just removing the suture.
The sutures are placed to prevent bleeding. The the tube is then cut and a segment is removed. The suture eventually dissolves and the tubal ends will be both separated and closed.
Ligation and resection tubal ligations are most often performed during a c-searean delivery or soon after a vaginal delivery.
There are many variations to this type of tubal ligation and these procedures are named after the doctor who first described the procedure: Parkland, Pomeroy, Irving, and Uchida.
Although there are differences in these procedures they all involve similar steps: tying the tube to prevent bleeding and cutting a portion of the tube to further reduce the risk of tubal ligation failure.
In our experience, all of these methods can usually be reversed and the chance of becoming pregnant after reversal of any of these methods is approximately 60 to 70%.
Parkland tubal ligation
Parkland procedure involves tying two sutures around the fallopian tube in the middle of the fallopian tube cutting out the tubal segment between the two sutures.
When the sutures dissolve the ends of the tube will be closed and pregnancy will not occur.
The Parkland tubal ligation is a variation of a ligation and resection type of tubal ligation.
Approximately 60 to 70% of our patients will become pregnant after a reversal of a Parkland tubal ligation.
Pomeroy tubal ligation
The Pomeroy procedure is also a ligation and resection type of tubal ligation.
The Pomeroy procedure involves forming a loop in the middle of the fallopian tube, tying a segment of the looped fallopian tube with a suture, and removing a segment of the loop.
Pomeroy tubal ligation technique typically leaves two healthy segments of fallopian tube that can be rejoined through tubal ligation microsurgical reversal surgery.
The Pomeroy tubal ligation is a variation of cutting and tying a tube. As with all of these procedures the technique will cause permanent closure of the tubal ends and prevention of pregnancy.
As with all of these types of tubal ligations the majority of these procedures can be reversed.
Approximately 60 to 70% of our patients will become pregnant after a reversal of a Pomeroy tubal ligation.
Irving and Uchida tubal ligation
Irving tubal ligation is also a ligation and resection type of tubal ligation.
Tubal ligation by the Irving method starts by placing two sutures around the fallopian tube in the middle of the tube and removing the small segment of tube between the two sutures. The tied end of the segment of fallopian tube attached to the uterus is sutured into the back side of the uterus and the other tied end is buried in the connective tissue underlying the fallopian tube.
As with other ligation/resection methods, the Irving technique leaves behind two healthy tubal segments that can be rejoined through tubal reversal microsurgery.
Although the Uchida tubal ligation is not illustrated here it is a variation of the Irving technique and the Uchida procedure is also reversible.
The pregnancy rates after reversal of Irving and Uchida tubal ligations is approximately 60-70%.