Wednesday, June 27, 2018

A Few Essentials On Tubal Reversal Surgery

By Karen Morris


The fallopian tubes form a vital part of the female reproductive system. It links the ovaries on either side to the uterus. Eggs released from the ovaries find their way to the fallopian tubes where they meet with sperms for fertilization. Tying the fallopian tubes bilaterally interferes with the natural conception process. Tubal reversal surgery is ideal for women whose tubes may have been tied accidentally or those who change their minds regarding this method of family planning.

History, physical examination and investigations are necessary before the doctor decides that surgery can be undertaken. A good rapport should be created between the doctor and the patient so that relevant medical details can be revealed. Any past illnesses involving the genitourinary system should be documented. This could be infection, malignancy, congenital malformations and so on. Any operations done previously should also be taken in to consideration. Common operations that can interfered with reversal include myomectomy, cesarean section, management of an ectopic pregnancy and so on.

Following history taking is physical examination to rule out any signs of infection or other condition that may impact negatively on reversal surgery. Blood tests and imaging relevant to the case in question are also carried out. Typically, ultrasound is done to examine the status of the reproductive system and whether the tubes can be salvaged.

Pinhole surgery is an alternative to open method for reversal. The only disadvantage of this method is that it takes times to be mastered. The good thing about it is that it is of short duration and does not invade the tissues too much. The patient is put to sleep through anaesthesia to ensure they are not traumatized by the procedure.

Women whose age is above forty stand minimally chances of pregnancy after reversal of fallopian tubes ligation. The presence of too many adhesions, as occurs after performing surgeries, impairs the ability of a woman to conceive even after the tubes have been untied. Underlying fertility problems may also work against a couple trying to have a child.

Complications of ligation reversal surgery are bound to happen, just like in any other surgical procedure. During the intra operative period, the patient may bleed excessively. Apart from bleeding, damage to surrounding structures is also a possibility. Infection may come later on during the recovery period. Formation of scar tissue is another bother as it may result in tubes getting blocked again. The chances of getting ectopic pregnancies after reversal are very high.

Some of these complications can be minimized by observing certain measures including administration of prophylactic antibiotics and observing sterility when handling the internal environment of the body. In addition, blood tests should be done before the operation to ensure the hemoglobin levels are within normal to cater for blood loss during surgery.

In conclusion, there is room for reversal even after tubal ligation. The size of the remaining tubes determines whether the procedure will be successful or not. It is done by unclipping the area and suturing together the open ends. Women below the age of forty are more likely to get pregnant after the reversal operation.




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