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. If you had your tubes tied when you had a c-section or right after you delivered vaginally this is the type of tubal that you have and Pomeroy’s are good for 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 nice but not 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 had our first baby born from an Essure reversal in February 2010. As of the summer of 2012, we have done over 60 of these reversals.

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