Robotic microsurgical tubal surgery

Yes. Patients who have undergone tubal ligation are the best candidates for robotic microsurgical tubal reversal surgery. The possibility of reversal surgery depends on the type of tubal ligation done i.e. whether it was done using cautery, clip or ring. The functional length of the tube left after the ligation is the important factor in success. An average tube is 10 cm long. If the tubal ligation surgery removed a significant part of the tube as done in salpingectomy, the length of the tube after reversal surgery will be short. No part of the tube is removed in ligation procedures using the clip (Filchie clip) or the ring (Fallop ring) rather the tube is mechanically occluded.  This allows for excellent results after reversal surgery as only a minimal portion of the tube need to be removed at the time of reversal surgery.

Yes. It depends on how much of the tube was cauterized at the time of tubal ligation. If the cautery was used for the entire length of the tube during the tubal ligation procedure, then no normal tube remains.  If only one area of the tube was cauterized there is a good chance for reversal surgery.

The first step is to make a consultation appointment with Dr. Jacob at the center. Please call our office at 314-473-1285 or click here to make the appointment. It is a good idea to bring the operative report, as well as the pathology report, from your tubal ligation procedure to your initial consultation appointment. The pathology report will show how much of the tube was removed, while the operative report will show what type of tubal ligation surgery was done, like cautery, clip, ring or excision of the tube.

After review of the operative report and pathology report, a determination is made whether you would be an ideal candidate for robotic microsurgical tubal reversal. If you are and you wish to proceed, you will undergo testing which include an ultrasound scan, hormone blood work on the third day of your period, a hysteroscopy and a semen analysis for your male partner (if applicable). All these tests can be completed with 14 days of the beginning of your cycle.

You will have a follow up meeting at the Center to discuss the test results. If the results are normal, we will discuss with you the robotic microsurgical tubal reversal surgery procedure in detail. The next step is to schedule the surgery at the hospital which will be done by the center after insurance authorization (if applicable).  You may have to do pre-operative testing at the hospital usually one week prior to surgery.

You will be discharged from the hospital after overnight stay at the hospital. You will have your 1 week post op check up at the office. All these appointments and instructions will be emailed to you after the surgery has been scheduled.

Three months after surgery you will have a HSG test at the hospital to see whether the tubes have healed and are open. If the tubes are open you may try to conceive naturally. You will then be referred back to your referring OB/GYN doctor.