Infertility Treatments > Surgical > Tubal Reanastomosis

    There are many different reasons that individuals decide to try to have their tubes untied, including remarriage and a simple desire for more children. The fallopian tubes are, however, never actually tied. There are many different ways of doing a tubal ligation, but they all involve destroying or removing at least a small portion of the tube. This can range from removal of a small piece of the tube to destruction or removal of the entire tube.

    Some tubal ligations can be reversed (the tubes put back together), and some can not. In general, the more of the tube that was destroyed at the time of the tubal ligation, the poorer the chances of successful function after tubal reanastamosis are. If only a small piece of tube is missing, surgery for putting the tubes back together (reanastamosis) is very successful. This type of tubal ligation is commonly referred to as a Pomeroy-type tubal ligation. Postsurgery pregnancy rates of eighty percent or more are expected following reanastamosis. In general, this is one of the few types of tubal ligation that should be treated with reanastamosis rather than In Vitro Fertilization.

    The use of cautery to do a tubal ligation also makes it less likely that the tubes can be repaired. Any type of cautery increases the amount of the tube that is damaged and irreparable, and often cautery is performed in more than one place on the tube.

    The primary determinant of the success of tubal reanastamosis is the length of the tube remaining after reanastamosis. The more of the tube that is destroyed at the time of "tubal ligation," the less successful the reanastamosis will be. If the post-reanastamosis length of the tube is less than six centimeters, the chances are very compromised indeed.

    Reanastamosis is performed through a small laparotomy incision under general anesthesia. A microscope is used for visualization purposes. Using meticulous micro-surgical technique, we reanastamose the tubes using 8-0 vicryl in multiple layers. This typically requires a one night stay in the surgery center. Dr. Jarrett has performed hundreds of reanastamoses, with excellent success rates.

© 2005 Jarrett Fertility Group