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Tubal Ligation Methods and how they relate to your chances of a successful
tubal ligation reversal
We often get questions such as “my doctor told me he cut tied and
burned my tubes-can I have a tubal ligation reversal? The answer is we need
to look at the tubal ligation operative
note dictated by the doctor when he or she did your tubal ligation.
Some methods that sound pretty horrible actually don't damage much tube.
When your tubal ligation reversal is done you want to end up with as much
length as possible. The fallopian tube is not only a passage for the egg
to meet up with the sperm and travel to the womb, it is a place where the
fertilized egg matures and gets ready to implant into the wall of the womb.
If the tube is too short the egg does not have enough time to get ready
for implantation and no pregnancy develops.
Clips and Bands Tubal Ligation
This type of tubal ligation is usually very reversible. There is plenty
of tube left to repair and makes the tubal
ligation reversal a fairly simple procedure.
Pomeroy Tubal Ligation
In this method of tubal ligation, a loop of tube is “strangled”
with a suture. Usually, the loop is cut and the ends cauterized or “burned“.
This type of tubal ligation is often referred to as cut, tied, and burned.
These are usually very good for reversal. The fact that the ends are burned doesn't matter
because that part is going to be lost anyway during the tubal reversal.
Irving or Uchida Tubal Ligation
In this type of tubal ligation, the portion of the tube near the uterus
is folded on itself and buried. These are reversible usually. The "away"
part of the tube nearest to the ovary is not damaged. This method tubal
ligation is both least likely to fail and usually easy to reverse.
Parkland Tubal Ligation
This is a variation on the pomeroy tubal ligation technique, the tube is
tied off and a portion removed. These can be reversed if not too much tube
is removed. Again, the op note is critical.
Fimbriectomy Tubal Ligation
This is an older technique where the end of the tube is removed. Doctors rarely
use this method anymore. We can sometimes
repair this type of tubal ligation by plastic microsurgery to the end of
the tube. The name of the operation to repair this type of tubal ligation is a Neofimbrioplasty. This type of reversal does not work as well as the other types because the end of the tube does not function as well. Pregnancy rates with this type of reversal are 30-40% depending on the patients age.
Burning Tubal Ligation
There are two types of burns. Bipolar, where a hot clip is touched to the
tube and unipolar where electric current is passed through the tube. Hardly
anyone uses unipolar burning because it’s unpredictable and very dangerous.
Bipolar burns can usually be reversed. The first thing we need to do is get a copy of your doctor's dictated
operative note from your tubal ligation. This will tell us how your tubes
were tied and if they can be reversed. We will get it for you from the hospital.
You can download
the tubal ligation operative note request form or we will mail it to
you. Whatever method was used to tie you tubes, this is the first step in
getting your tubal ligation reversed.
Essure and Adiana Tubal Occlusion
These newer type of tubal occlusion. We can reverse the Essure and Adiana types
of tubal occlusion. This is a separate type of procedure and those seeking
reversal of the Essure or Adiana contraceptive devices should call for details.
To reverse these, you need to do a procedure called cornual implantation.
We have just started doing these reversals and we are expecting our first baby born
from an Essure reversal in February 2010.
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"Whatever method was used to tie you tubes, this is the first step
in getting your tubal ligation reversed."
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