Laparoscopic Tubal Recanalization

Tubal sterilization is currently the most popular form of birth control in India. Tubal sterilization or tubal ligation is done popularly by open method or laparoscopically.

In open method both the fallopian tubes are tied in its central part and small segments are cut, where in; in laparoscopic sterilization a band is applied on the fallopian tube so that it permanently occludes the tube.

In some cases, such a woman may seek reversal due to unforeseen events such as death of the only male child/ desire to have more children or undergoing a second marriage.

Microsurgical technique for reversal of tubal ligation is known as tubal recanalization-Tuboplasty or simply tubal reversal surgery.

Traditionally this surgery is known as microsurgery in which very thin fallopian tube as thin as a refill of a ball pen is repaired. The lumen of the tube is less than a millimeter and is repaired by skillful approximation of the two ends to each other so that the tube will be able to carry out the process of transfer of the egg and the sperm and embryo.

The outcome following tubal microsurgery depends upon 3 factors:
1. The women’s general and reproductive health
2. The effect of sterilization procedure on the tubes.
3. The technique and surgical skill used to anastomose the tube.

Besides these, we have also found that age of the patient, type of anastomosis, length of the remaining tube after sterilization, time interval between sterilization and reversal procedure all played a very important role in success of the operation as far as pregnancy is concerned.

Laparoscopic Tubal Recanalization:

Laparoscopic tubal recanalization is highly skillful surgery in which fallopian tubes are repaired using very thin suture material (Thread) –As thin as hair of an eyebrow.
We use smaller 3 mm size instruments to conduct the procedure. The segment of the fallopian tube where previous ligation was done is cut so as to get fresh and healthy tube with lumen inside and both the cut ends are sutured together so as to get hollow lumen in continuity with each other.

Our experience in Laparoscopic tubal recanalization:

Tubal reversal surgery is highly skilled surgery. Traditionally it is done by open method by almost all gynaecologists. We are doing this procedure by laparoscopy since last 5 years at Yashadaa with good success rate. Success rate of this procedure done at Yashadaa hospital is touching almost 70-80%.
Few patients have become pregnant twice after this procedure done by us. Only one patient has landed up in ectopic pregnancy after this surgery, but fortunately her next pregnancy was normal pregnancy and she delivered a healthy boy also. Dr.Sandeep Patil and Dr. Sayalee Patil have been called to perform these surgeries at other hospitals in Mumbai, Pune, Satara, Barshi-Solapur etc.

Advantages of Laparoscopic Tubal recanalization:

 Laparoscopic Tubal recanalization is safe, less painful. Patient recovery is very fast as compared to traditional Tubal recanalization. Patient can be discharged practically on very next day of the surgery.

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