No. Most patients cannot believe how well the do after minilaparotomy tubal reversal. Because of our experience of over ten years with minilaparotomy we have a plan to reduce your discomfort to a minimum. There are many little things that we do that ad up to your getting quickly back to normal after reversal of your tubal ligation.
We do not use mechanical retractors to hold the incision open. We make a small [2 to 3 inch] incision and move it around to each side as needed. We also move your uterus underneath the skin opening. The combination of these two things makes a large incision and a hospital stay unnecessary. I was the first person I know of anywhere in the world to do major gynecologic surgery through a minilaparotomy incision. I first did a hysterectomy this way 12 years ago and just now my method is being reported in the medical journals.
Tubal reversals are microsurgical procedures. I tell patients that it is like operating in a dime-sized area and trying to sew President Roosevelt’s eye shut. Because the tubal reversal involves only a small area on both sides of the pelvis, not a lot is disturbed and there is minimal, if any, deep pain. To keep the incisional pain to a minimum, each layer is injected with a long acting anesthetic. Our technique is gentle and minimally invasive.
By using head mounted loupes, magnifying devices, the incision in your lower abdomen can be smaller and a smaller incision means less pain after your tubal ligation reversal.
If you ask around, you will find those that say a microscope is better for tubal reversal, but I don’t think that’s true. Not everyone can use loupes because you have to hold your head very still for a long time. Those that can, do. The microscope does not move with the surgeon’s head so the incision in your abdomen has to be wider and that means more pain after your tubal reversal and sometimes a hospital stay. The magnification is the same.
As soon as we open your abdomen to reverse your tubal ligation we fill it with a special solution to seal it from air. This reduces the inflammation in your pelvis that occurs when the delicate structures are exposed. This exposure adds to postop discomfort and can cause adhesions to develop. If you ever have played with super glue you know what adhesions look like. Just put a drop on your thumb and touch your index finger to your thumb. The stringy lines look just like adhesions.
If your tubal ligation was done as an outpatient, you will almost certainly have less pain with tubal reversal. Most patients are back pretty much back to normal after 2 days some people rest up for a week. You are not to do strenuous activity for 3 weeks; light exercise is fine as soon as you feel like it. Everyone is different and we know that you may need an extra dose of TLC and we are anxious to give it.