Tubal Anastomosis historically was considered to be major surgery requiring an abdominal incision. We are very excited to offer Laparoscopic Tubal Anastamosis, a procedure done only in a select few centers worldwide. While our former open surgery technique was done as an outpatient with relatively rapid recovery, Laparoscopy shortens the recovery to 2-5 days from 10-20 days. The surgery itself takes approximately 1 1/2 hours and we will be using operative laparoscopy with newly developed fine microsurgical instruments. We use very fine sutures which are smaller than human hair. This allows for better healing and a smaller chance for the tubes to scar closed as they heal. This all combines to optimize your chances of pregnancy.
Because traditional laparoscopic surgery with such fine suture is very difficult, most programs offer only the open approach. Utilizing our vast experience with advanced traditional laparoscopy for other conditions, we have refined our techniques for this procedure as well. With the advent of the robot, laparoscopy for tubal reversal will become more commonplace. The disadvantages of the robot are its great expense and that it will add time to the procedure. We have been able to keep our cost down without an increase even with the laparoscopic procedure. Our all inclusive price is the lowest in the country for a laparoscopic tubal reversal. Call the office at 904-493-BABY(2229) for details.
Most patients are back to work and resume normal activity by 2 to 5 days. The only limitations to outpatient laparoscopic tubal reversal are no lifting over 15 lbs. for 3 weeks and no driving for 24hrs, otherwise you may do whatever you feel like doing. Intercourse to achieve pregnancy can be resumed after ten days.
Success rates of tubal anastomosis vary according to the type of tubal ligation which was previously performed. For most non-cautery (“burning” of the tubes) post-operative patency (open tubes) rates are 90+% with pregnancy rates in the 80+% range. If the procedure can be performed on a woman who has had her tubes cauterized, her subsequent pregnancy rate is less (approx. 60%). The pregnancy rate depends on several factors. The length of the tubes at the conclusion of surgery is very important, as is the condition of the ends of the tubes (fimbriae). Also, patient age and other fertility factors can play a role in the determination of post-operative pregnancy rate. Additionally, because we are working on the inside of the tube, there is a small increase in tubal pregnancy (5% of subsequent pregnancies). Overall, though, the procedure is very safe and we have had excellent results. At times patients are pregnant in the first cycle after the surgery.
The alternative to tubal anastomosis is in-vitro fertilization (IVF). In this therapy, the ovaries are stimulated to produce many eggs which are harvested and fertilized in the laboratory and replaced into the uterus, thereby bypassing the tubes. This therapy offers a “take home baby” rate of 25-50% per cycle at an average cost of 30% more than that of tubal anastamosis surgery. When 3 cycles of “IVF” are planned, the overall take home baby rate is 50-90%. Therefore, roughly 3 IVF cycles are required statistically to give the same pregnancy rate as tubal anastamosis surgery. The rate of multiple gestation (twins, triplets, etc.) is increased with IVF. There are some important differences to consider when comparing the two options. If tubal surgery is successful, it can be reused, so-to-speak, to obtain subsequent pregnancies, if so desired, with little risk of twinning. To the contrary, if only one child is desired, IVF offers the opportunity for pregnancy without a major surgical procedure. Tubal reversal surgery also allows couples to conceive naturally without the use of artificial means.
Laparoscopic Tubal Reversal Surgery is very affordable at our center. Please call the office for details in your case - 904-493-BABY (2229)
Prior to scheduling this surgery, a consultation appointment with Dr. Fox or Lipari is necessary. It is best if we have the operative note from your tubal ligation at that visit. We will also perform an ultrasound and recommend a semen analysis prior to surgery. We look forward to helping you achieve your pregnancy goals. This is understandably a very important decision for you and we also appreciate the great stress that you are under at this time. We will do everything in our power to make this process as easy and comfortable as possible.
