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What is Tubal Reversal/Reconstructive Surgery?

Sterilization is a permanent method of contraception for women desiring not to become pregnant in the future. The laparoscopic technique is a minimally invasive procedure and in recent years laparoscopic sterilization has gained popularity owing to its advantages over the traditional approach. Laparoscopic sterilization is a technique of tubal ligation to block or close the fallopian tubes, the pathway for sperm to reach eggs for fertilization. 

Fallopian tubes, located on either side of the uterus, pick up eggs released from the ovaries and transfer them to the uterus. If these tubes are blocked, sperm fail to reach the eggs and fertilization will not occur. 

Reversal after sterilization is a surgical procedure to restore fertility by restoring the normal functionality of the fallopian tubes that were blocked during sterilization.  About 5-10% of women may require a reversal of sterilization, due to various reasons such as having a new partner and desire for additional children. Women whose tubes were removed during the sterilization cannot have a reversal.

Factors Influencing Reversal of Sterilization

The major factors that may affect the results of reversal after sterilization are as follows:

  • Age
  • Condition of the tubes
  • The regularity of the menstrual cycle
  • Fertility of partner
  • Problem with other parts of the reproductive system

Prior to the reversal surgery, patients should undergo a screening that includes:

  • Physical examination
  • Medical history
  • Series of laboratory tests
  • Review of the medical reports of sterilization methods
  • Evaluation of the partner’s fertility

Procedure of Reversal Surgery

Reversal after sterilization is a safe procedure that involves the following steps:

  • The operation is performed under general anesthesia
  • A small incision, approximately 10-12 cm in length, is made across the lower abdomen and a laparoscope is inserted.
  • The fallopian tubes are identified and isolated.
  • Magnification and microsurgical techniques are used to repair the fallopian tubes.
  • The ends of the tubes are trimmed to remove any damaged tissue.
  • The inner open space of the tube, called the lumen, is exposed.
  • These openings are then fused using microscopic sutures, followed by the suturing of the outer covering of the tubes called serosa.
  • The repaired fallopian tubes are placed back into their respective positions and the incision is closed.

Post-operative care for Reversal Surgery

The procedure may take a few hours and the patient is usually discharged on the same day of the procedure. Patients are advised to follow the instructions given by their surgeon, along with the recommended diet and prescribed medications. Patients can perform their routine activities such as driving, walking, etc., after a few days of the surgery. Complete recovery of the patient may take a few days to a few weeks. 

Risks and complications of Reversal Surgery

The possible risks associated with reversal of sterilization include:

  • Infection
  • Bleeding
  • Scarring of the tissue
  • Chances of ectopic pregnancy
American College of Obstetricians and Gynecologists American College of Surgeons American Board of Obstetrics and Gynecology