What is a Tubal Reversal? What is an Essure Reversal?

Tubal reversal is a surgical procedure which involves reconnecting a women’s fallopian tubes once they have been “tied,” “clipped.” “banded,” or “cauterized” (tubal ligation).  If you have an Essure it will require more extensive surgery including removal of the damaged segment of the uterus, with reimplantation of tube.  Of the methods listed, application or a ring or clip to the tube has the best outcome following tubal reversal because these methods involve the least amount of tubal damage.  The second method, removal of a portion of the fallopian tube, is the most commonly utilized procedure when the tubal ligation is done immediately following delivery (post-partum).  Typically, only 1 to 2 centimeters of fallopian tube are removed, usually involving the mid-segment of the fallopian. This type of tubal ligation is generally amenable to tubal reversal as well.  The length of fallopian tube removed at the time of sterilization will impact the outcome of the reversal.  An estimate of the length of tube removed can be obtained from the surgical report and pathology report.  The pathology report is generated at the time tubal ligation to confirm that a segment of fallopian tube was removed.  Infrequently, the fimbriated end of the fallopian tube is removed as a method of sterilization.  The fimbriae are finger-like projections of the fallopian tube that move over the surface of the ovary and are critical in picking up the egg at the time of ovulation.  This type of tubal ligation may or may not be able to be reversed by making new openings in the ends of the tubes.  This is called a neo-salpingostomy.  Pregnancy rates with this procedure are somewhat lower than with a traditional tubal reversal.  It should be noted that with any tubal surgery there is an increased risk for an ectopic pregnancy, therefore, careful follow up during the early pregnancy should be done to decrease the potential complications should such an even occur.

 Laparoscopic Tubal reversal and Essure reversal are both done using the DaVinci robotic surgery system.  4-6 tiny incisions are closed with stitches which will reabsorb; therefore, there are no staples to remove.  The patient is discharged home the day after surgery.  By the following day regular food and light activity can be resumed.  It is recommended to avoid heavy foods until good bowel functions have returned.  After discharge, the patient may shower.  It is normal to have a small amount of clear or blood tinged fluid leak from the incision.  If you have excessive fluid or if the fluid looks like pus,  you should call Dr. Neef, an experienced robotic surgeon in Burleson.  Likewise, notify Dr. Neef if you are unable to eat, drink, go to the bathroom, have temperature >100.4, or if your incision looks red, feels warm to the touch or comes apart.