Reclaim Your Fertility
Robotic surgery can reverse tubal ligations and Essure procedures
Overview
Gynecological surgery specifically aimed at restoring or maintaining reproductive function is called reproductive surgery. There are three methods by which typical gynecological surgeries are performed. These include the old-fashioned “open” method, standard laparoscopy, and Robotic Assisted Microsurgical techniques. Traditional open gynecological surgery often requires larger abdominal incision. The open incision method causes more scarring and patients have a much longer recovery. Through laparoscopy, patient recovery is much faster, and less scarring inside occurs. However, this procedure can be performed more precisely with the da Vinci Robotic surgical system. Robotic surgery is used to gain extraordinary precision and exceptional range of motion – movements that the surgeon would be unable to perform manually. Miniaturized surgical instruments are inserted through laparoscopic openings as small as half a centimeter, and a small camera is inserted through a separate incision. The doctor then controls the instruments using a high-definition video feed. Seated close to the patient, he remotely uses precise, smooth, and effortless movements, enhanced by the wristed capabilities of the robotic arms. The increased range of motion, enhanced vision, and mechanical precision of robotic surgery ultimately allows for reproductive surgeries providing several advantages to ensure that you have the best possible outcome.
Dr. Neef has been specifically trained to be attentive to a woman’s future reproductive needs. His goal is to minimize the negative impact of surgery on the reproductive organs. Typically, minimally invasive procedures can be done in a day-surgery setting. By using this cutting-edge technology with Dr. Jason Neff, is able to provide more successful outcomes for a number of conditions including tubal ligation reversal, Essure reversal, and hysterectomies.
Robotic Tubal Reversal
Reversal of traditional tubal ligation is performed using the DaVinci robotic surgery system and involves removing the cauterized (burnt) ends of the fallopian tube and then reanastomosing (reconnecting) the two ends together resulting in a normally functioning tube. The patient will have 4-5 tiny incisions of their tummy. The procedure usually takes 1-2 hours and most patients go home the next day. You will be given a prescription for pain medicine to take at home. Recovery time is around 1 week.
Read MoreEssure Reversal
Dr. Neef is one of only a few doctors nationwide to perform the Essure reversal using the DaVinci robotic platform. The procedure involves resection of a portion of the uterine cornua (corner) with removal of the Essure device. The remaining fallopian tube is then reintroduced into the uterus and sutured in place. This procedure usually takes around 2 hours to perform. Patients are usually discharged the following day with a prescription for pain meds. Recovery time is around 2 weeks.
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Robotic Hysterectomy
Hysterectomy is the surgical removal of a woman’s uterus. Removal of her ovaries is sometimes performed but not always necessary. Indications for the procedure are heavy, painful periods, irregular periods, endometriosis, postmenopausal bleeding, uterine fibroids, pelvic pain and cervical dysplasia not amenable to removal by other means. Dr. Neef performs most hysterectomies by using the DaVinci robotic surgery system. The patient will have 4-5 tiny incisions of their tummy. The procedure usually takes about an hour and most patients go home the same day. You will be given a prescription for pain medicine to take at home. Recovery times varies from woman to woman but is usually around 2 weeks.
Read MoreGet the answers to your questions
Talk with Dr. Neef about your gynecological needs.
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 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. 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.
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