522 N. New Ballas, Suite 206
St. Louis, Missouri 63141
Phone : 314 473 1285
Fax : 314 473 1287
After Hours : 314 277 8782

..where everyone has a chance to start a family

Robotic microsurgical tubal surgery

Robotic Microsurgical Tubal Reversal

Tubal reversal surgery is a complex surgical procedure where the previously tied Fallopian tubes are reopened. Traditionally this procedure required a laparotomy where the patient’s abdomen is opened. The tied ends of the tube are freed and the lumen of the tubes are opened on either side by excising the scarred ends. Next the ends of the tubes are sutured together using very small sutures. The procedure can be done using an operating microscope which will result in a fine approximation of the tubal ends. Next the abdominal opening is closed. The success rate with this method of open tubal reversal with or without operating microscope is usually 50%. This reduced success rate is due to the scarring caused by the laparotomy and poor approximation of the cut end of the tubes. Recently, microsurgical tubal reversal has been done using the robot. Here the procedure is done with the assistance of the robot and without doing a laparotomy. Through 3 or 4 small “key hole” incisions with the assistance of the robot, microsurgical tubal reversal surgery is performed. In addition to the magnification of the surgical field this procedure gives 3 dimensional view so the repair can be done with higher precision. With robotic microsurgical tubal reversal the success rate is as high as 90%. At our center, Dr. Jacob performs robotic microsurgical tubal reversals with high success rates. Please call our office at 314-473-1285 or click here to make a consultation appointment.

Q1. My tubes were tied after the birth of my last baby. Can I have tubal reversal surgery?

Yes. Patients who have undergone tubal ligation are the best candidates for robotic microsurgical tubal reversal surgery. The possibility of reversal surgery depends on the type of tubal ligation done i.e. whether it was done using cautery, clip or ring. The functional length of the tube left after the ligation is the important factor in success. An average tube is 10 cm long. If the tubal ligation surgery removed a significant part of the tube as done in salpingectomy, the length of the tube after reversal surgery will be short. No part of the tube is removed in ligation procedures using the clip (Filchie clip) or the ring (Fallop ring) rather the tube is mechanically occluded.  This allows for excellent results after reversal surgery as only a minimal portion of the tube need to be removed at the time of reversal surgery.

Q2. My doctor did tubal ligation using cautery. Can I have reversal surgery?

Yes. It depends on how much of the tube was cauterized at the time of tubal ligation. If the cautery was used for the entire length of the tube during the tubal ligation procedure, then no normal tube remains.  If only one area of the tube was cauterized there is a good chance for reversal surgery.

Q3. I have decided to proceed with tubal reversal surgery. What should I do next?

The first step is to make a consultation appointment with Dr. Jacob at the center. Please call our office at 314-473-1285 or click here to make the appointment. It is a good idea to bring the operative report, as well as the pathology report, from your tubal ligation procedure to your initial consultation appointment. The pathology report will show how much of the tube was removed, while the operative report will show what type of tubal ligation surgery was done, like cautery, clip, ring or excision of the tube.

Q4. What other testing should I do before the tubal reversal surgery?

After review of the operative report and pathology report, a determination is made whether you would be an ideal candidate for robotic microsurgical tubal reversal. If you are and you wish to proceed, you will undergo testing which include an ultrasound scan, hormone blood work on the third day of your period, a hysteroscopy and a semen analysis for your male partner (if applicable). All these tests can be completed with 14 days of the beginning of your cycle.

Q5. I have completed the pre surgery testing. What is the next step?

You will have a follow up meeting at the Center to discuss the test results. If the results are normal, we will discuss with you the robotic microsurgical tubal reversal surgery procedure in detail. The next step is to schedule the surgery at the hospital which will be done by the center after insurance authorization (if applicable).  You may have to do pre-operative testing at the hospital usually one week prior to surgery.

Q6. I had the surgery. What are the next steps?

You will be discharged from the hospital after overnight stay at the hospital. You will have your 1 week post op check up at the office. All these appointments and instructions will be emailed to you after the surgery has been scheduled.

Three months after surgery you will have a HSG test at the hospital to see whether the tubes have healed and are open. If the tubes are open you may try to conceive naturally. You will then be referred back to your referring OB/GYN doctor.