Tubal Ligation – Fimbriectomy
Tubal Reversal is Possible after Fimbriectomy
Fimbriectomy tubal ligation
Tubal ligation by fimbriectomy involves removing a portion (usually up to one-third) of the fallopian tube closest to the ovary. With microsurgical techniques, the end of the remaining fallopian tube can be opened and the inner tubal lining gently folded outward over the cuff to improve the chances of egg capture. This tubal reversal procedure is called microsurgical salpingostomy.
Reversing Fimbriectomy tubal ligation
It is generally thought that tubal reversal cannot be successful following a fimbriectomy because of the loss of the important egg-capturing fimbria. Fortunately, the inner lining of the remaining tube also has the cilia that help transport the egg into and down the tube once it has been reopened. Cilia are particularly abundant in the ampullary portion of the fallopian tube. The length of the remaining tube and presence or absence of its ampullary segment can be determined by x-ray (hysterosalpingogram). This is recommended prior to undergoing a salpingostomy procedure. The pregnancy rate after fimbriectomy tubal reversal is 30-40%.
Tubal ligation procedures
Normal fallopian tube anatomy and other tubal ligation procedures described in the following pages are:
- Pomeroy Tubal Ligation
- Tubal Rings and Clips
- Monopolar and Bipolar Tubal Coagulation
- Parkland and Irving Procedures
- Essure and Adiana (Hysteroscopic Procedures)