Pathology Reports Before Tubal Ligation Reversal

At Chapel Hill Tubal Reversal Center, we want to maximize the chances for pregnancy after tubal ligation reversal for all of our patients. One step that is helpful in planning for a tubal reversal procedure is examining the pathology report from a patient’s medical record. Pathology reports can provide critical information to a tubal reversal specialist since they convey additional information beyond what is contained in the operative report describing the tubal ligation.

What is a pathology report?

A pathology report- sometimes shortened to ‘path report’- is a typed report from a pathologist (doctor who studies healthy and diseased tissue) that describes the removed tubal segments. Usually when tissue is removed by a surgical operation, it is sent to a pathologist for examination. After this examination, a pathologist will create a typed report describing what was observed.

When a tubal ligation and resection procedure has been performed, a segment of fallopian tube was removed and most likely sent to a pathologist. Therefore, a pathology report should exist in the patient’s medical record. When a sterilization has been performed by tubal electrocautery or with tubal clips or rings, there will not be a pathology report because no tubal tissue is removed with these tubal ligation methods.

A pathology report will help our tubal reversal doctors determine exactly what was done during a ligation and resection procedure and what your chances of tubal reversal success will be.

Examples of Pathology Reports After Tubal Ligation

Here are some examples of what the pathology reports may show after a tubal ligation and resection:

Scenario 1
Operative note states, “A standard ligation and resection was done.” Pathology report states, “Two 1.5 cm isthmic sections of fallopian tube were examined.” In this case, the pathology report confirms that small amounts of isthmic tubal segments were removed and the chance of successful ligation reversal is very good.

Scenario 2

Operative note states, “A bilateral ligation was done…tubes were resected.” Pathology report states, “Two 4 cm sections of fallopian tube were examined and fimbrial ends were present on both sections.” In this case, the pathology report demonstrates that the patient has had a fimbriectomy. We would advise the patient that fimbrectomy reversal will be the appropriate procedure to reverse this type of tubal ligation.

Scenario 3
Operative note states, “A typical bilateral tubal ligation was done.” Pathology report states, “Two 7 cm section of fallopian tubes were examined.” In this case, the pathology report shows that large amounts of tubal length were removed. This is not a typical bilateral tubal ligation, and the chance of a reversing tubal ligation is remote. In this case, we would advise the patient that IVF would be a better treatment option for her than tubal reversal surgery.

Get Expert Opinion

As tubal reversal experts who specialize in ‘untying tied tubes’, we have found that most tubal ligations are reversible. Any patient considering ligation reversal should send us a copy of their operative reportand, if ligation and resection was done, a copy of the pathology report. We will review these reports, without charge, and provide the best recommendation for becoming pregnant after tubal ligation.

Submitted by Dr. Charles Monteith
Chapel Hill Tubal Reversal Center

Frequently asked questions regarding operative reports

Operative Reports Before Ligation Reversal Surgery

Undergoing a tubal ligation reversal at Chapel Hill Tubal Reversal Center is an important endeavor and we want to maximize every patient's chance of ligation reversal success. Operative reports are important because they allow us to determine the likely success of tubal ligation reversal surgery. When the operative report is not available, we offer the option of starting with a screening laparoscopy. The choice of whether to start with screening laparoscopy is up to the individual patient. Since most tubal ligation procedures are reversible, it is an option, and not a requirement at Chapel Hill Tubal Reversal Center.

What is an operative report?

An operative report is a typed report describing exactly what the doctor saw and did during your tubal ligation procedure.

Where can tubal ligation operative reports be obtained?

Tubal ligation operative reports can be obtained from the hospital or health care facility where you had your tubal ligation surgery. Your doctor may have a copy of your operative report in their office. The hospital will have a copy of the report in your hospital record and will keep them on file for a limited time.

How long does the hospital keep my operative report?

The time a health care facility will keep records will vary by state. Most states have laws specifying how long records must be kept. If a state does not have laws regarding keeping medical records, then the state medical board will have guidelines which the board encourages physicians to follow. North Carolina, for instance, has no state laws mandating how long medical records will be kept. The North Carolina State Medical Boards recommends physicians keep records for a minimum of 10 years. Medicare and Medicaid records are recommended to be kept for a minimum of five years.

The physician’s office or hospital will typically keep records in their file room for a limited time and then transfer the files to another storage area for several years. Some facilities will create digital records of your health care information and store this information indefinitely.

How can I obtain an operative report?

Contact the medical records department of the hospital where your tubal ligation was performed. You will have to fill out a medical records release form. The operative report can be mailed or faxed to you and to our facility. Please be aware some medical facilities are very busy and have limited medical record personnel. This means they may take some time to send records and you might have to keep a close watch to make sure the records are actually sent in a timely fashion. Chapel Hill Tubal Reversal Center has instructions and a form you can use to obtain a copy of your operative report.

What happens if I can not get my operative report?

If you can not get your operative report you can try to get your doctor to give you more information about the type of ligation surgery you had. Although this is not as accurate as an operative report, this can provide some information. Many doctors will do their tubal ligation surgeries the same way over many years and they should be able to tell you how your procedure was done.

Your best option is to consider a screening laparoscopy. This involves placing a small telescope under your umbilicus (belly button) and looking at the fallopian tubes. This provide quick and accurate information about the condition of your fallopian tubes. When the screening laparoscopy is performed here, we proceed immediately with the tubal repair. If the laparoscopy shows that the tubes cannot be repaired, the procedure is ended without the laparotomy incision and a partial refund is given to the patient.

Will Chapel Hill Tubal Reversal do my reversal surgery if I do not have an operative report?

Yes. We frequently encounter many patients who are unable to obtain their operative report. The choice of whether to start with screening laparoscopy is up to the individual patient. Since most tubal ligation procedures are reversible, it is an option, and not a requirement.

Read More about Operative Reports Before Ligation Reversal Surgery

Tubal Ligation Reversal - Untying Tied Tubes

Untying Tied Tubes: Bipolar Electrocoagulation

History of Tubal Sterilization

The first tubal sterilization procedure, reported in 1881, was tubal ligation and resection. Ligation and resection - or ‘tying tubes’ was the most common surgery for sterilization until the advent of laparoscopic surgery in the mid 1900’s. As laparoscopic surgery became more popular, electrocoagulation (electrical burning) of the fallopian tubes became an additional method of surgical sterilization. Tubal sterilization by electrocoagulation uses electric current to cut and destroy the portion of the tube that is exposed to the electric current. These portions of the tube eventually heal and close.

Monopolar Tubal Coagulation

The initial method of laparoscopic tubal coagulation, in 1962, used a type of electrical current termed monopolar current. Monopolar tubal electrocoagulation was a popular type of laparoscopic sterilization through the 1970’s and 1980’s. The medical community began to realize that the complication rate from this form of electric surgery was higher than for other electric surgical methods of tubal sterilization. Sterilization procedures done by monopolar current have gradually been replaced with bipolar current.

Bipolar Electrocoagulation of the Fallopian Tubes

The first reported sterilization using bipolar electrocoagulation was in 1972. This was done via a laparoscope inserted just under the belly button. During bipolar coagulation, the electrical current can be more precisely controlled, resulting in less tubal damage than monopolar coagulation. This sterilization procedure results in higher reversal success rates than monopolar electrocoagulation.

Reversing Tubal Sterilization

Many people, including doctors, mistakenly believe that tubal sterilization is permanent and irreversible. Although bipolar coagulation sterilization is intended to be permanent, this procedure can be reversed successfully in almost all cases. The success rates depend on how many different areas of the tube were damaged with electrocautery. Approximately 60- 70% of patients at Chapel Hill Tubal Reversal Center become pregnant after a reversal of a bipolar coagulation sterilization procedure. Chapel Hill Tubal Reversal Center is the only medical facility that specializes exclusively in reversal of tubal ligation. We perform tubal ligation reversals every day, and our tubal reversal doctors are experts in reversing all types of tubal ligations- or ‘untying’ tubes that have been ‘tied’!

Untying Tied Tubes: Falope Ring Sterilization

Falope Ring Sterilization

The Yoon Falope rings were developed in the 1960’s as a safer alternative to laparoscopic monopolar cautery tubal sterilization. This procedure is performed by inserting a laparoscope just under the belly button. The fallopian tube is then identified and a device holds the tube while the silastic ring is slid over a 2-3 cm ’knuckle’ of tube that is kinked off by the ring. This is done once for each side.

The common misperception is that the Falope ring is what prevents pregnancy and that reversal of the procedure simply requires removal of the ring. The Falope ring causes the squeezed ’knuckle’ of tube to undergo avascular necrosis (to die and become absorbed by the body). After this happens the ends of the tubal segments outside the ring close up, thereby preventing sperm from reaching the egg.

Falope Ring Sterilization Reversal

Reversing Falope ring sterilization is not as easy as just removing the ring. The closed ends of the tubes must be opened and the tubal segments must be rejoined.

Falope rings cause destruction of a minimal length of fallopian tube and reversal of this type of tubal ligation gives excellent results. Approximately 75% of patients at Chapel Hill Tubal Reversal Center become pregnant after a reversal of a Falope ring sterilization procedure.

Many people believe tubal sterilization is permanent and irreversible. Although tubal sterilization with Falope rings is intended to be permanent, this procedure can be reversed. Chapel Hill Tubal Reversal Center is the only medical facility that specializes exclusively in reversal of tubal ligation.

Untying tied tubes: Hulka clips

Hulka Clip Sterilization

One common form of female sterilization is the use of Hulka clips to block the fallopian tubes. The Hulka clip was approved for use in the United States in the 1970’s and was invented in Chapel Hill, North Carolina by Dr. Jaroslav Hulka at the University of North Carolina at Chapel Hill.

The Hulka clip is a small, gold plated stainless steel spring loaded clip. The clip in introduced into the abdominal cavity via a laparoscopic clip applicator. This image shows the open clip in the applicator and the tip of the laparoscope with its fiber optic lighted end. When the clip is placed across the fallopian tube, it is closed and a small spring holds the clip firmly across the tube. The Hulka clip has the advantage of damaging only a very small portion of the fallopian tube- approximately 7mm (the thickness of three quarters stacked on each other).

The Hulka clip causes bilateral tubal occlusion by squeezing a very small portion of the tube. The squeezed portion is deprived of its blood supply and eventually undergoes avascular necrosis (dies and is absorbed by the body). This causes the fallopian tube to be divided in half and the two ends to close up. The Hulka clip is held in place between the two divided tubal segments by a small amount of scar tissue which forms within the clip.

Hulka Clip Reversal

A common misconception is that the Hulka clips can simply be opened to reverse the sterilization process - that the tubes can be unclipped. Unfortunately, tubal ligation reversal for Hulka clips is not as simple as opening the clips. Hulka clip tubal occlusion is reversed by removing the section of the tube with the clip across it and then, using microsurgical techniques, joining the remaining tube segments back together in perfect alignment.

Tubal reversal of Hulka clip tubal occlusion is better than for most other methods of sterilization because such a minimal amount of tube is destroyed in the occlusion process. Approximately 76% of patients at Chapel Hill Tubal Reversal Center become pregnant after a reversal of a Hulka clip sterilization procedure.

Common Misconception About Tied Tubes

Many patients seem to imagine the fallopian tube is like a shoe lace which is tied up like a bow to prevent pregnancy. As tubal ligation reversal specialists, we wish it were that easy- then untying tied tubes would be easier!

‘Tying ones fallopian tubes’ is a common language phrase used to describe several different surgical procedures which result in sterilization (a procedure intended to permanently prevent pregnancy). The more correct medical term is bilateral (both sides) tubal occlusion (closure of the fallopian tube).

There are many different ways to occlude (close) the fallopian tubes: ligation and resection (tying and cutting), clips and rings, and coagulation (burning). No matter how the procedure is done the end result causes the tube to close, heal shut, and prevent sperm from fertilizing an egg.

Tubal Sterilization is Reversible

Many people believe tubal sterilization is permanent and irreversible. Although Hulka clip sterilization is intended to be permanent, this procedure is ideal for tubal reversal. The Chapel Hill Tubal Reversal Center is the one medical facility which specializes in tubal ligation reversal.

We have become experts in reversing all types of tubal ligations- or ‘untying’ tubes that have been ‘tied’!

Untying Tied Tubes: Filshie Clip Sterilization

Tying Tubes is Not Like Tying a Shoe Lace

Many patients seem to imagine the fallopian tube is like a shoe lace which is tied up like a bow to prevent pregnancy. As tubal ligation reversal specialists, we wish it were that easy- then untying tied tubes would be easier!

‘Tying fallopian tubes’ is a common language phrase used to describe several different surgical procedures that result in tubal sterilization (a procedure intended to permanently prevent pregnancy). The more correct medical term is bilateral (both sides) tubal occlusion (closure of the fallopian tube).

Tubal Ligation Methods

There are many different ways to occlude (close) the fallopian tubes: ligation and resection (tying and cutting), clips and rings, and coagulation (burning). No matter how the procedure is done the end result causes the tube to close, heal shut, and prevent sperm from fertilizing an egg.

Filshie Clip Tubal Ligation

One common form of laparoscopic (camera) sterilization is the use of Filshie clips to occlude both fallopian tubes. The Filshie clip was approved for use in the United States in the mid 1990’s. The Filshie clip is a small titanium clip which is lined with a thin silicone cushion. The clip was an improvement over the Yoon Falope Ring and the Hulka Clip because it was as easy to apply with less risk of operative complications. The clip also has the advantage of destroying only a very small portion of the fallopian tube- approximately 4mm (approximately the thickness of two quarters stacked on each other). The adjacent tube is not affected. The majority of Filshie clips placed in the United States are done by laparoscopic surgery; however, there is a growing trend to use them for tubal occlusion at the time of cesarean delivery (c-section).

The Filshie clip causes bilateral tubal occlusion by squeezing a very small portion of the tube. The squeezed portion is deprived of its blood supply and eventually undergoes avascular necrosis (dies and is absorbed by the body). This causes the fallopian tube to be divided in half and the two ends to close up. The Filshie clip is held in place (in between the two divided ends) by a small amount of scar tissue which forms over the clip.

A common misconception is that the Filshie clips can simply be removed to reverse the sterilization process- that the tubes can be unclipped. Unfortunately, tubal ligation reversal for Filshie clips is not as simple as just opening the clips. Filshie clip tubal occlusion is reversed by removing the clips and using microsurgical techniques to open the closed ends and join the tubal segments back together in perfect alignment.

The reversal of Filshie clip tubal occlusion is usually technically easier than some other methods of sterilization because such a minimal amount of tube is destroyed in the occlusion process.

Approximately 76% of patients at Chapel Hill Tubal Reversal Center become pregnant after a reversal of a Filshie clip sterilization procedure.

Tubal Sterilization Can Be Reversed

Many people believe tubal sterilization is permanent and irreversible. Although Filshie clip sterilization is intended to be permanent, this procedure can be reversed. Chapel Hill Tubal Reversal Center is the one medical facility that specializes in tubal ligation reversal.

We have become experts in reversing all types of tubal ligations- or ‘untying’ tubes that have been ‘tied’!

Untying Tied Tubes

Tying Tubes

Many people seem to imagine the fallopian tube is like a shoe lace that is tied in a bow to prevent pregnancy. As a tubal ligation reversal specialist, I wish it were that simple- then reversing tied tubes would be a whole lot easier!

Perhaps a well meaning doctor may have told a patient one day, “I am going to tie your tubes so you don’t get pregnant.” Maybe the doctor wrote a letter to a medical journal explaining the procedure and then the terminology stuck. More likely, a reporter may have simplified the terminology for the surgical procedure of tubal ligation to make a catchy title for an article. Others may then have started using the term “tying tubes” to quickly explain a complex procedure. These explanations often have a long life span and make their way into common language.

The more accurate terminology is bilateral tubal occlusion (closure of both fallopian tubes) which results in sterilization (not being able to conceive). There are many ways to perform bilateral tubal occlusion. The most common tubal sterilization procedure is performed at the time of cesearean delivery (c-section) or immediately after having a baby. It does involve tying the tubes with a suture - but then also cutting out a segment of healthy tube, resulting in closure of the tube as it heals. The suture then dissolves. The intial suture tying is most likely where the phrase ‘tying tubes’ came from.

Another common method is to burn the tubes with electrical energy (electrocoagulation). This is usually done by laparoscopic surgery and is usually done remote from pregnancy. Lastly, there are many devices- clips and bands - which can close off the tubes and cause a portion of the tube to be destroyed.

No matter how the procedure is done, the end result is obstruction of the fallopian tube that prevents pregnancy.

Many people believe that tubal sterilization is irreversible. Although bilateral tubal occlusion is intended to be permanent, the procedure can be reversed. Chapel Hill Tubal Reversal Center is the one medical facility that specializes exclusively in reversal of tubal ligation. We have become tubal ligation reversal experts………experts at untying tied tubes!

Tubal Reversal Information

Tubal reversal information is plentiful on the internet, but not everything that you read is accurate or factual. Of the websites that provide information about tubal ligation reversal, the one from Chapel Hill Tubal Reversal Center is most complete and accurate. It describes the various types of tubal ligation procedures and the different tubal reversal procedures that can be used. If you are interested in learning about tubal reversal, spend some time looking at the different pages on this extensive site. There is a search box at the top of every page that can direct you to specific information about any issues relating to tubal ligation reversal. Take a look also through the many topics of information on the Tubal Reversal Blog.

Tubal Reversal Surgery

Tubal ligation reversal is usually considered to be a major operation, taking several hours and requiring a hospital stay of 1 to 5 days. Complete recovery is often described as taking 4 to 6 weeks. However, the tubal reversal procedure that Dr. Berger has developed is performed as outpatient surgery with no hospital stay required and with complete recovery generally within 5 to 10 days. Since hospitalization is not required, the cost of the tubal reversal procedure is reduced by half or two-thirds of the cost when performed in a hospital. Patients are more comfortable during their post operative recovery and are able to return to work and other normal activities much faster. A free video or DVD of Dr. Berger’s tubal reversal procedure is available on the Chapel Hill Tubal Reversal Center website.

Risks of Tubal Reversal

As with any surgery, complications are always a possibility. Although rare, these may include bleeding, infection, damage to other organs, or complications of anesthesia. The most significant risk associated with tubal ligation reversal is the long term risk of having an ectopic pregnancy. This risk is increased from approximately 2% of pregnancies in the general population to approximately 10% after tubal reversal. Fortunately, the medical problem of a ruptured tubal pregnancy can be prevented by following an early pregnancy monitoring protocol that has been described by Dr. Berger and is recommended to all women after a tubal reversal procedure.

Alternative Treatment

Rather than “untying” their tubes, some women are advised to be treated by in vitro fertilization (IVF). However, IVF is more complicated and expensive, the pregnancy rate after IVF is not as high as after tubal reversal, and there is a very high incidence of multiple births (approximately 30%) after IVF. Further, there is concern about the possible long term effect of the use of potent hormones to stimulate the ovaries to produce many eggs (called “super-ovulation”) and the suspicion that it might increase the risk of ovarian cancer later in life.

Am I a Candidate for Tubal Reversal?

Although most women have been told that tubal ligation is permanent, in fact, the vast majority of tubal ligation procedures are reversible. The operative report from your tubal ligation will give a good indication if the procedure can be reversed. When there is any doubt about this, diagnostic laparoscopy can be performed to examine the fallopian tubes and then decide whether to proceed with the reversal operation.

Pregnancy Rates After Tubal Reversal

Pregnancy and birth rates after a tubal reversal are significantly better than after IVF. Neither procedure, however, can guarantee that pregnancy leading to birth will occur. Even when the fallopian tubes have been repaired, other factors – such as age, menstrual cycle regularity, ovulation or other hormonal disorders, and the fertility of the male partner - may determine when, or whether, conception will occur.

Women under the age of 30 who have a tubal reversal have an 82% pregnancy success rate; between 30-34 the pregnancy rate is 76% and for women ages 35-39, the pregnancy rate is 67%. The pregnancy rate declines for women 40 and older in accordance with the natural decline in fertility with age. However, pregnancy rates are higher for women of any age following tubal reversal than after IVF.

More Tubal Reversal Information

If you would like to discuss your individual situation with a Tubal Reversal Nurse, call (919) 968-4656. The experienced nurses at Chapel Hill Tubal Reversal Center are always happy to provide information about tubal ligation reversal. You can also exchange information with other women on the Tubal Reversal Message Board.

Tubal Ligation and Tubal Reversal News: 2007

Past topics in the Tubal Reversal Blog include posts and comments about patient care at Chapel Hill Tubal Reversal Center. This topic summarizes important articles about tubal ligation and tubal reversal reported in the news during 2007.

Sterilization is Most Popular Family Planning Method
Approximately 10 million American women use the pill for contraception, while sterilization has been chosen by 15 million men and women.

One In Five Women Regret Decision For Tubal Ligation
One in five women under age 30 who undergo tubal sterilization later regret the procedure, despite the number of children they have.

Is Sterilization the Best Contraception Choice?
Women requesting a tubal ligation should be counseled regarding other long-term, reversible methods of contraception and informed that vasectomy is safer and more effective than tubal ligation.

Tubal Ligation Counseling Issues
Counseling about tubal ligation should include permanence of the method, possibility of future regret, and information about the specific techniques of tubal sterilization.

Relationship Conflict Before Sterilization
Women whose relationship was marked by substantial conflict before they underwent tubal ligation were most likely to regret the decision.

Young Age, Prodding Partner and Sterilization Regret
Young age and a prodding partner are risk factors indicating that a woman undergoing sterilization may later regret her decision.

Tubal Reversal Among Overweight Women
Overweight women’s chances of becoming pregnant after tubal reversal improve when they lose weight.

Dr. Berger’s Comment

These news reports touch on some of the issues patients talk about when they come to Chapel Hill Tubal Reversal Center for tubal sterilization reversal. The popularity of tubal ligation, and the fact that many women regret their decision to have a tubal ligation, are well documented. Young age and marital conflict are risk indicators for subsequent regret. Before performing a tubal ligation, doctors should ensure that the implications of ending childbearing potential are clearly understood and discuss vasectomy as an alternative permanent method of birth control. Women undergoing tubal reversal who are overweight should be aware that losing weight will improve their chances of becoming pregnant again.

Consenting to Tubal Ligation During Childbirth

I received an email message today from a patient that prompted me to write about informed consent for tubal ligation. (See my previous blog about informed consent for tubal reversal.) Here is the message that was sent to me.

Hello, Dr. Berger,

You performed tubal reversal surgery on me on 10/29/07, and I just found out that I’m pregnant. Thank you so much! This is such a blessing. I filled out the report and have heard back from Sarah Meacham. I’ll make sure to follow her instructions.

I’m writing because I have a friend named Samantha who wants to get reversal surgery, but she would like to make sure she’s a candidate based on the information in her operative report. I told her that I would send it to you so you can look it over, so it’s attached. She and her husband have two cute little girls, but she agreed to the tubal ligation on the operating table after she gave birth to her youngest at the prodding of her doctor. She said that she made a terrible mistake and wants more children. And like me, no one she’s asked in south Florida will even consider the procedure that you do. When I told her about you, she was ecstatic. And now that I’m pregnant, she knows that it works!

Thank you again for the miracles you work for so many women. God bless you and your staff!

Sincerely,
Amy P.

I was glad to hear that Amy was pregnant and had recommended to Samantha that she come here for her tubal reversal procedure, but this part of the message caught my attention:

“…she agreed to the tubal ligation on the operating table after she gave birth to her youngest at the prodding of her doctor. She said that she made a terrible mistake…”

What Is Informed Consent?

Before performing a tubal ligation - an elective operation - a doctor should always obtain the patient’s informed consent. Informed consent is the process through which the patient becomes educated about the procedure - including its benefits, risks and alternatives - and makes the decision to have the procedure performed. Informed consent implies that the patient fully understands the issues, has asked any questions she has, had her questions answered, and makes her decision under no duress. Adequate time should be allowed for a patient to think about all of the issues before consenting to the operation.

Should Consent For Tubal Ligation be Made During Childbirth?

Many tubal reversal patients have told me that the first time they discussed a tubal ligation with their doctor while they were on their way to the operating room for a C-section. Some regretted their decision while they were on the operating table or when they awoke in the recovery room. Other patients have said they had a tubal ligation in response to pressure from their spouse, parents, or their doctor. Labor and delivery is not the best time to think about an issue with such profound and lasting results as surgical sterilization. This should be discussed and thought about at leisure, not during the stress of childbirth.

Dr. Berger’s Comment

Besides the doctor’s responsibilities in obtaining informed consent, the patient also has a responsibility when giving it. A tubal ligation is not an emergency operation. Having a tubal ligation is a decision that should be carefully considered and not made in haste. There is adequate time during the pregnancy for a doctor and patient to discuss the issue of sterilization. Bringing this up for the first time on the way to the delivery room is a mistake, in my opinion. A more deliberate approach to the process of informed consent by both doctor and patient would help avoid mistaken decisions, such as in Samantha’s case.

Is Tubal Ligation Regret A Big Problem?

At Chapel Hill Tubal Reversal Center, we receive requests 7 days a week, 365 days a year, for information about tubal ligation reversal. These requests come from women who regret having a tubal ligation. A staff member recently asked me how big a problem this is throughout the country. The following is in response to this question.

How Many Women Have Had A Tubal Ligation?

There is no single data source reporting the number of surgical sterilizations performed in the United States. Based on multiple sources of information, it is likely that 650,000 to 700,000 tubal sterilizations are performed each year, and more than 11 million American women have had a sterilization operation. The latest study, conducted in 2002 by the US Department of Health and Human Services, indicates that between one in four to one in five of adult, sexually active women have had a tubal ligation.⁽¹⁾

How Common Is Tubal Ligation Regret?

Many factors can affect a woman’s likelihood to regret sterilization. Among women who had a tubal ligation, risk factors for regret include young age, less education, and a husband or partner who wanted the woman to have a tubal ligation.

In 1999, a study called the Collaborative Review of Sterilization (CREST) found that 20% of women who were sterilized before the age of 30 regretted their decision. Women who were sterilized at a young age had a higher chance of requesting information about reversal, regardless of their number of living children. Also, women who reported conflict with their husbands or partners before tubal sterilization were more than three times as likely to regret their decision and more than five times as likely to request a reversal than women who did not report such conflict. ⁽²⁾

Dr. Berger’s Comment

This statistical information helps give a broader picture to the significance of the issues and comments raised in the previous blog topic - Ethics of Tubal Ligation. Additional comments on this issue are welcome from all readers.

References

1. MMWR Surveillance Summary, “Contraceptive Use — United States and Territories, Behavioral Risk Factor Surveillance System, 2002.
2. Mosher WD, Martinez GM, Chandra A, Abma JC, Wilson SJ. Use of contraception and use of family planning services in the United States: 1982–2002. Hyattsville, MD: US Department of Health and Human Services, National Center for Health Statistics, 2004. Advance Data from Vital and Health: no. 350.

Tubal Reversal After Fimbriectomy Tubal Ligation

Tubal Ligation by Fimbriectomy

Fimbriectomy is an infrequent type of tubal ligation in the United States. This female sterilization method is performed by removing the fimbrial end of the fallopian tube. At the fimbrial end of the tube, the inner tubal lining faces outward towards the ovary. The tubal lining is rich in cilia that beat in coordinated waves to pull the egg into the tubal opening.

Many doctors think that tubal reversal cannot be successful following a fimbriectomy because of the loss of the egg-capturing fimbria. This is a mistaken notion. Cilia are abundant in the ampullary segment of the fallopian tube. The inner lining of the remaining ampullary tubal segment can be folded outward after opening the tube and can function as a new fimbrial end. The tubal reversal procedure for fimbriectomy reversal is called ampullary salpingostomy.

Fimbriectomy Reversal Pregnancy Rates

Chapel Hill Tubal Reversal Center publishes statistics updated annually regarding pregnancy rates and pregnancy outcomes for all of the women who have had tubal reversal procedures performed by Dr. Berger. The data for women who had tubal ligation procedures by fimbriectomy are from our Tubal Reversal Pregnancy Study Report 2007.

The overall pregnancy rate after fimbriectomy tubal reversal is 56% for patients at Chapel Hill Tubal Reversal Center. The following table shows the numbers and pregnancy rates according to womens’ ages at the time of their tubal reversal procedure.

Pregnancy Rates After Fimbriectomy Reversal

Age	All Women	Pregnant (#)	Pregnant (%)
<30	29	20	69%
30-34	82	52	63%
35-39	131	81	62%
40+	70	22	31%

Recommendations for Fimbriectomy Reversal

The success of fimbriectomy reversal depends upon having an adequate length of ampullary segment of the fallopian tube. The length of the remaining ampullary tubal segment can be determined from a hysterosalpingogram (HSG) or from diagnostic laparoscopy.

I recommend having an HSG or choosing the screening laparoscopy option when tubal ligation has been performed by fimbriectomy. An HSG can be ordered by the patient’s local doctor and the x-ray films sent to me for examination prior to scheduling tubal reversal surgery. Alternatively, patients can omit having an HSG and schedule their reversal surgery to start with screening laparoscopy. This will show if ampullary salpingostomy will be effective. If so, the tubal reversal procedure will be performed at the same time while the patient is under anesthesia.

Women From Georgia Who Want To Have Tubal Reversal Surgery With Dr. Berger

A member from the Chapel Hill Tubal Reversal Center message board is trying to connect with other women in her area who want to make the trip to Chapel Hill Tubal Reversal Center for surgery with Dr. Berger. The message board offers women a place to ask questions, post information, and to develop friendships with other women who are in similar situations. Patients come from all over the world to have surgery with Dr. Berger. Dr. Berger has perfected tubal reversal microsurgery into a one-hour surgical procedure.

This enables Chapel Hill Tubal Reversal Center to offer a reduced fee of $5,900. When comparing procedure expenses at other clinics, even after travel costs, you will save money. When women compare the fact that Dr. Berger's facility is a clinic designed specifically for tubal reversal procedures in the convenience of an outpatient setting, and that he brings 30 years of expertise to the field of tubal reconstruction surgery, most women quickly discover that Chapel Hill Tubal Reversal Center offers the best value, quality, and care.

This is topic Anyone in or around Georgia?? in forum New Message Board Members at Tubal Reversal Message Board.

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Posted by lydiayvette1 (Member # 11964) on April 04, 2008 08:35 PM:

Pls share if there is someone near Atlanta. I'd love to hear from you. :-)

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Posted by Jo Ann01 (Member # 3764) on April 04, 2008 11:30 PM:

Hi there - I am just north of Atlanta in Rome. I had my TR in 2002, my TR baby in 2004 and am now TTC TR baby#2. I always love seeing the GA girls on the board!!
Jo Ann

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Posted by in-Gods-hands (Member # 11795) on April 05, 2008 01:46 PM:

I wish you all the best. I live in NC. Around 4-6 hours from you. Miranda
TR 3-24-2008

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Posted by georgiamom (Member # 11089) on April 05, 2008 05:30 PM:

I am just outside of ATL in Loganville. I had my TR in June 2007 and am currently 10.5 weeks pg with TR baby #1.
Jen

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Posted by TrishJ913 (Member # 11468) on April 06, 2008 01:56 AM:

Hi there, lydiayvette1...
I am in Newborn, which is about 50 miles east of Atlanta. I don't post on the message board an awful lot, but I'm here reading it almost daily! I am hoping to have my TR in August of this year. I'm 38 and my husband of 18 months is 41 years old. We have 6 kids between the two of us from previous marriages, but we'd love to have one of our own. It's always nice to see another lady from Georgia on here! Welcome!
Congratulations, Jen and JoAnn!

And hello, Miranda! Didn't wanna leave you out of the greetings!
~Trish

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Posted by songofjoy (Member # 11442) on April 06, 2008 10:05 AM:

Hey all, I too am from Ga I live in Flowery Branch Ga. Nice too know someone close by...
Carol Scott
TR-09/10/2007
BFP-02//02/2008
EDD-10/14/2008

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Posted by georgiamom (Member # 11089) on April 06, 2008 10:25 AM:

Carol and Trish,
You are both about 40 minutes from me and Jo Ann Rome is about two hours. So glad to know that there are GA girls so close by!!
Jen

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Posted by TrishJ913 (Member # 11468) on April 06, 2008 04:55 PM:

Hi there, Carol! Nice to meet you all. I'm not sure if this is within the message board rules or not - I hope it's ok - but my email is silverstang91369@aol.com if any of you would like to chat or email sometime. It's always nice to have someone to keep in touch with who knows and understands what you're going through with this journey! I hope you all have a great week!

~Trish [Kiss]

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Posted by sbbradford (Member # 11748) on April 06, 2008 08:23 PM:

i'm from hartwell ga, about 100 miles from atlanta. i'm close to the s.c. line. Sheila

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Posted by in-Gods-hands (Member # 11795) on April 06, 2008 08:37 PM:

songofjoy, this may be personal and you do not want to answer and that is fine. But I had my TR on 3-24-08 and have healed fast. Still waiting on my first AF after the TR. When did you start TTC? I am worried we will start trying to soon. I wish you all the very best on your BFP. Miranda

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Posted by songofjoy (Member # 11442) on April 07, 2008 11:21 AM:

in-Gods-hands,
I waited till my first period then tried after that...took only about 3 months. I wish you baby dust!!!
Carol

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Posted by in-Gods-hands (Member # 11795) on April 07, 2008 12:56 PM:

Carol Thank you so very much..

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Posted by georgiamom (Member # 11089) on April 08, 2008 10:50 AM:

Just wanted to say good morning and give the GA girls a little bump to the top.
Hope everyone is well and is enjoying this gorgeous weather and that the pollen hasn't completely buried you!!
Have a great day!

Jen

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Posted by anxioustoknow (Member # 12305) on April 16, 2008 01:43 PM:

Hi there-I am about 3hrs south of Atlanta in Sandersville. Haven't had TR yet just considering. Just got remarried and my husband doesn't have any children,I have 3 from my first
marriage.

Dianne

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Posted by armywife4 (Member # 9891) on April 16, 2008 01:53 PM:

Hey there! We are stationed at Fort Stewart, GA...3ID! Hope everyone is doing well! Just wanted to say Howdy!
Becky
TR 12/27/06
1st TR Baby Benjamin Josiah born 10/20/07
TTC TR baby #2 in July!!

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Posted by sassyfrass (Member # 12332) on April 25, 2008 12:18 PM:

Im from Royston Georgia and Im new to all this, not quite sure how the boards work, but anyway I was wondering how painful the TR surgery actually is? and how long is the recovery period? I just had back surgey and want to have the TR as soon as Im recovered

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Posted by georgiamom (Member # 11089) on April 25, 2008 12:55 PM:

sassyfrass,
Its not too bad at all. For me the worst day was the day of and the day after, but not something that wasn't manageable. Ice packs really help and within about 5 days I really felt like my old self.
Good luck!

Jen

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Posted by cf4063 (Member # 11864) on April 25, 2008 12:57 PM:

HEllo!! I am Charity from Rome, Ga. My stats are:
ME:27
DH:28
DS:11
DS:8
DS:6
DSS:4
TL:2002
TR:2-27-08
Nice to see all you Ga peaches!!

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Posted by a_dean2006 (Member # 12340) on April 29, 2008 08:38 AM:

Hi everyone I am Sandersville, GA and I am researching doctors that are qualified to do TR their is a doctor here and we are looking at Aug 08 but I want to be sure that he is qualified I have had all of the pre-work up done and myself and my husband are looking forward to having the surgery done

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Posted by nwinston (Member # 12321) on April 29, 2008 08:54 AM:

a-dean2006- Hi, Im nwinston, I live in Tn and my TR is sch for 5-19-08. I dont know how far I am from you. Im in Knoxville. My DF and I will be driving 6 hours to see Dr Berger. Im really excited. I did research a Dr in Gainsville and several in Knoxville before I chose Dr Berger. Some in Knoxville were even a little cheaper but I felt that Dr Berger was the best choice for me.

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Posted by a_dean2006 (Member # 12340) on April 30, 2008 09:28 PM:

Hi again my I am Angelica and I would like Diane to e-mail if you don't mind a_dean2006@yahoo.com I would like to ask questions since we both live in sandersville

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Posted by Hopingfortwo (Member # 12373) on May 13, 2008 06:38 AM:

I am in Rome,GA also.

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Posted by happyGAcouple (Member # 11208) on May 16, 2008 01:16 PM:

Hey all, I am also from Georgia, Brunswick. My fiance was stationed at FT Stewart 3ID, but he got out a year ago. We are getting married this July on st Simon\'s at the lighthouse, and we are hoping to schedule my TR before the end of the year.I have ds almost 13 and dd almost 10 and fiance has dd almost 11. We want to have a baby together to complete our family. I have some work to do before surgery, i have to loose weight and stop smoking... I know very bad habit but I will loose it before surgery.

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Posted by in-Gods-hands (Member # 11795) on May 16, 2008 04:54 PM:

happy.. I am not a GA girl but wanted to say welcome and I wish you all the best. I live in NC.

I wish you all great journeys. Miranda

Easy Recovery After Tubal Ligation Reversal Surgery

Pam Mills, a Certified Registered Nurse Anesthetist (CRNA), shares her story of working as part of the anesthesia care team at Chapel Hill Tubal Reversal Center. Pam has been working with Dr. Gary Berger spanning two decades and believes her experience with Dr. Berger has given her the opportunity to work one-on-one with tubal reversal patients in an outpatient setting and to ensure they receive the best medical care they have ever experienced. Ms. Mills explains that the anesthesia team talks with patients individually so gather information about past anesthesia experiences and to develop a personalized anesthesia plan. But Pam is also a believer in the power of positive thinking and works closely with patients to ensure they are calm and informed, with the seed of positive thought planted. She and the rest of the anesthesia staff go the extra mile to ensure the patient's safety, comfort, and sense of well-being before, during, and after the tubal reversal procedure.

Anesthesia for Tubal Ligation Reversal

Submitted by Pam Mills, CRNA

Being part of the anesthesia care team at Chapel Hill Tubal Reversal Center has given me the opportunity to work one on one with tubal reversal patients in an outpatient setting and to assure they receive the best medical care they have ever experienced.

For anesthesia purposes, we record pain scores and the incidence of postoperative nausea for all of our patients. We conduct comprehensive reviews of our data and implement changes to our anesthesia protocol, if necessary. This performance improvement activity is the beauty of working in a small private setting.

All of our patients receive individual attention and care. We have had patients tell us, “This is the first time in my life I have not been sick after anesthesia!” and “This was the easiest anesthesia I have ever had!”

I can’t think of anything more rewarding than to have helped our patients have a safe and pleasant experience while they are here for their tubal ligation reversal procedures.

Personalized Anesthesia Plan

If a patient tells me that she experienced nausea after an anesthetic in the past, I sit down with her and discuss our anesthesia plan and how it is designed to optimize her comfort and well being during her postoperative recovery. I want her to be confident that she will be well taken care of and that we will do everything in our power to make this anesthetic different from what she experienced previously. Our patients receive two medications through their IV to prevent nausea, and for patients with special needs I give what is is fondly referred to as my “special cocktail”. This cocktail has a combination of two additional anti-nausea medications, also given through the IV before the patient wakes up. This covers all the possible trigger centers in the body that can cause nausea.

Power of Positive Thinking

I usually end our discussion of postoperative nausea by telling the patient and family member that this will be the last we will mention of this subject, as I am a firm believer in planting the seed of positive thought. So from then on I want them to focus on positive thinking, knowing that she will be well taken care of and anticipating that she will wake up feeling well and free of pain or nausea.

Patient Care at Chapel Hill Tubal Reversal Center

Our dedication to patient care and outcome is evident in our patient follow up care. Every patient is entered into our computerized database. This database includes information from the day of surgery, their postoperative recovery, follow upcontacts by our nurses, as well as every pregnancy following the tubal reversal procedure through to its outcome. There is no better place for women to have tubal reversal surgery than at Chapel Hill Tubal Reversal Center. Our anesthesia staff goes to extra lengths to ensure the patient’s safety, comfort, and sense of well-being during and after the tubal reversal procedure.

Tags: anti-nausea medications, chapel hill tubal reversal center, nausea, outpatient anesthesia, pain, performance improvement, postoperative recovery, sick after anesthesia, tubal reversal procedure

1. May 5th, 2008 at 6:19 pm
   One of the benefits of having tubal reversal performed at Chapel Hill Tubal Reversal Center is the excellence and dedication of our professional staff that ensures safe and comfortable surgery for our patients. I believe we pay much more attention to the small details that make this a positive experience for each patient. I have received many messages from patients who have said it was the best medical experience they ever had. Pam’s explanation of the anesthesia component helps to explain why this is so.
   


2. Julia Smith RN Says:
   May 5th, 2008 at 6:45 pm

For many women, anesthesia is the scariest part of the surgical experience. I hope that reading about the anesthesia team at Chapel Hill Surgical Center - their experience, compassion, and professionalism - will go a long way toward alleviating some of those fears for our patients.

1. Rhonda Brown RN Says:
   May 5th, 2008 at 8:10 pm
   I think that this is wonderful information for our potential patients wanting to become pregnant after tubal ligation. I think one of the biggest fears that patients have is being put to sleep. I think that we have the best anesthesia team around. They truly put their patients’ safety first. They are dedicated to the best experience for all tubal reversal patients.
   
   
2. Charles Monteith MD Says:
   May 5th, 2008 at 10:09 pm
   The anesthesia team at the Chapel Hill Surgical center is very professional and impressive. It is a pleasure to come to work and experience the positive energy of Pam Mills. She is the best CRNA I have worked with!
   


3. Ericka Pamplin Says:
   May 6th, 2008 at 6:12 am
   Personalized anesthesia plans, documenting pain scores and constant review of performance is evident in the anesthesia team at Chapel Hill Tubal Reversal Center!
   


4. jgokun Says:
   May 6th, 2008 at 8:04 am
   All surgery patients are normally apprehensive about being put to sleep with general anesthesia. Chapel Hill Tubal Reversal patients may rest assured that they are receiving the best possible anesthesia care by a team that works with only our tubal reversal patients. Performing anesthesia for the same surgery and the same type of patient population allows the anesthesia team to provide the most specialized and highest quality anesthesia care possible.
   


5. Dr. Hertz Says:
   May 6th, 2008 at 9:03 am
   The Anesthesia Department works together with Dr. Berger and Dr. Monteith as team to provide the best individualized care for our patients. We look forward to meeting each of our patients, and personalizing their experience!
   


6. Sally Muncy RN Says:
   May 6th, 2008 at 10:44 am
   It is the personal attention and the attention to detail that most of the patients mention when I see them post operatively and in the post operative phone calls that I make. They really appreciate that they were free of nausea and acute pain even though this hasn’t been true for them in the past.
   


7. Stephanie Duncan RN Says:
   May 6th, 2008 at 11:32 am
   Pam and the whole anesthesia team do put a lot of time and thought into making the plan of care specific for each patient. Not everyone is alike and it is great that so much attention to detail is given to everyone who comes to Chapel Hill Tubal Reversal Center.
   


8. Brandon Martin-Williams ST Says:
   May 6th, 2008 at 12:02 pm
   I see it everyday and it still amazes me how well the patients do after their procedure. The anesthesia team here really knows their patients.
   


9. Matt Murphy ST Says:
   May 6th, 2008 at 1:49 pm
   Patients are always say that after there tubal ligation reversal surgery that they are amazed at how well they feel! The extra attention the patients receive is one of the many benefits of having their tubes untied here at Chapel Hill Tubal Reversal Center.
   


10. Donna Blalock RN Says:
    May 6th, 2008 at 2:06 pm
    Having the time to devote to each patient and give such personal attention,is one of my top reasons for working at Chapel Hill Tubal Reversal Center. The entire anesthesia team here is unlike any other facility I know.
    


11. Sarah Meachem RN Says:
    May 7th, 2008 at 10:54 am
    I have had many patients tell me that they can’t believe how easy the tubal reversal surgery was, particulary the anesthesia. The anesthesia department here definitely works as a team and strives to provide the best patient care for each and every woman.
    


12. Kathy Scrone ST Says:
    May 8th, 2008 at 8:30 am
    Pam has written an extensive and thoughtful description of exactly how individualized each patient is cared for at Chapel Hill Surgery Center. Patients can and do feel rest assured of their anesthesia experience and on their way to a positive recovery from their tubal reversal surgery.
    

Untying Tied Tubes

Tying Tubes

Many people seem to imagine the fallopian tube is like a shoe lace that is tied in a bow to prevent pregnancy. As a tubal ligation reversal specialist, I wish it were that simple- then reversing tied tubes would be a whole lot easier!

Perhaps a well meaning doctor may have told a patient one day, “I am going to tie your tubes so you don’t get pregnant.” Maybe the doctor wrote a letter to a medical journal explaining the procedure and then the terminology stuck. More likely, a reporter may have simplified the terminology for the surgical procedure of tubal ligation to make a catchy title for an article. Others may then have started using the term “tying tubes” to quickly explain a complex procedure. These explanations often have a long life span and make their way into common language.

The more accurate terminology is bilateral tubal occlusion (closure of both fallopian tubes) which results in sterilization (not being able to conceive). There are many ways to perform bilateral tubal occlusion. The most common tubal sterilization procedure is performed at the time of cesearean delivery (c-section) or immediately after having a baby. It does involve tying the tubes with a suture - but then also cutting out a segment of healthy tube, resulting in closure of the tube as it heals. The suture then dissolves. The intial suture tying is most likely where the phrase ‘tying tubes’ came from.

Another common method is to burn the tubes with electrical energy (electrocoagulation). This is usually done by laparoscopic surgery and is usually done remote from pregnancy. Lastly, there are many devices- clips and bands - which can close off the tubes and cause a portion of the tube to be destroyed.

No matter how the procedure is done, the end result is obstruction of the fallopian tube that prevents pregnancy.

Many people believe that tubal sterilization is irreversible. Although bilateral tubal occlusion is intended to be permanent, the procedure can be reversed. Chapel Hill Tubal Reversal Center is the one medical facility that specializes exclusively in reversal of tubal ligation. We have become tubal ligation reversal experts………experts at untying tied tubes!

Submitted by Dr. Charles Monteith

Tags: bilateral tubal occlusion, fallopian tube, laparoscopic sterilization, preventing pregnancy, reversing tied tubes, tie tubes, tubal ligation reversal experts, tubal ligation reversal specialist, tubal sterilization, tying tubes, untying tied tubes

This entry was posted on Thursday, May 1st, 2008 at 8:56 pm and is filed under tubal ligation, tubal reversal procedure, untie tubes. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

1. Julia Smith RN Says:
   May 1st, 2008 at 9:01 pm

   Women often receive little education from their doctors regarding sterilization before having the procedure performed. This information is a clear, simple explanation for the most common question we receive!

2. Rhonda Brown RN Says:
   May 1st, 2008 at 11:39 pm

   I think that this information will help many women out there understand what they actually had done at the time of there tubal ligation. Many times we get calls from patients who are upset when they find out that a piece of tube was actually removed. They often say, “I thought my doctor said he was just tying my tubes.” It is good to know that this procedure which is referred to as permanent in most cases is not so permanent after all. This is a great option for women out there who have had decided that they once again would like to have another child as well as those who have decided that they want to have a child for the first time.

3. Matt Murphy ST Says:
   May 2nd, 2008 at 6:29 am

   I believe that women should now what they are having done and have all questions answered about there tubal reversal procedures. One thing that I really enjoy about working at Chapel Hill Tubal Reversal Center is that it’s a more personal setting than any other clinic or hospital, and we take the time to fully educate patients them about their options regarding having tubes untied.

4. Ericka Pamplin Says:
   May 2nd, 2008 at 6:47 am

   Chapel Hill Tubal Reversal Center is the only medical facility specializing exclusively in tubal ligation reversal. The staff are dedicated and the care is more personalized than the care that is received in a large hospital. I am not aware of any other facility that provides support for non urgent concerns during the evenings, weekends and holidays.

5. Myrna White Says:
   May 2nd, 2008 at 7:22 am

   Thank you Dr. Monteith for the explanation, I believe alot of woment thought just what you stated , that the tubes are just tied off with something. Doctors have never gone into any detail to explain the actual precedure to women after child birth. I am sure the way you explained the precedure will help many women understand.

6. Stephanie Duncan RN Says:
   May 2nd, 2008 at 9:00 am

   Patients may find out how their tubes were tied by requesting a copy of their operative report from the hospital where the tubal ligation surgery was performed. Mail or fax us the oeprative report and Dr. Berger will review it free of charge. A nurse will contact you to discuss scheduling your tubal reversal surgery.

7. jgokun Says:
   May 2nd, 2008 at 10:41 am

   When a patient calls to inquiry about the tubal reversal for the first time, I ask them if they know what type of tubal ligation her doctor performed. The patient usually says “They were just tied”. Patients normally do not know that they in fact did not have their tubes “tied”, but rather clipped, burned, and/or resected. Lucky for our patients, Dr. Berger is able to repair the tubes in 98% of cases and has reversed all types of tubal ligations.

8. Pamela Mills CRNA Says:
   May 2nd, 2008 at 10:44 am

   A wonderful analogy, thank you Dr Monteith!

Another Day of Untying Tubes

The following is from the Tubal Reversal Blog where Dr. Charles Monteith reports his diary entries for another day of assisting Dr. Berger in untying tubes for patients at Chapel Hill Tubal Reversal Center.

Dr. Montieth’s Diary on Becoming a Tubal Reversal Specialist

Today we had another successful day of untying tubes. We began the day at 7AM. Four patients were scheduled for tubal ligation reversal surgery.

I was able to first assist Dr. Berger in the first three surgeries of the day, but had to leave prior to the fourth surgery. I am becoming proficient at identifying tubal anatomy and repairing tubes that have been tied.

The first patient had her tubes tied several years ago and she was now in a new relationship. Both she and her partner desired more children. They made the decision that they would undergo tubal ligation reversal and try to pursue their dream of having children together. Her surgery went well and we were able to successfully reverse her tubal ligation.

The second patient was similar to the first and desired more children. Her surgery also went well.

The third patient had her tubes tied, but after her surgery she lost a child to Sudden Infant Death Syndrome (SIDS). We often hear stories like this from many patients who come to Chapel Hill Tubal Reversal Center. It is extremely sad to hear the stories these patients tell. My heart aches for them as they try to replace their children and add to their family. Every time I hear these stories I think of my own children and what it would be like to experience such a loss. I can not fully imagine the pain from such loss but I can understand the strong desire to replace a cherished soul. I am happy to report that her surgery went extremely well and she had an excellent operative result. I take enjoyment out of every reversal surgery I have participated in, and feel an extra sense of accomplishment when assisting in untying tubes for patients who have lost children unexpectedly.

I had to leave before the fourth patient had surgery. Fortunately, I will be back in the morning for four more reversal surgeries and to meet four more interesting people and learn about their stories.

Tags: Dr. Monteith, repairing tubes, reversal surgery, SIDS, surgery, tied, tubal anatomy, tubal ligation, tubal ligation reversal, tubal ligation reversal specialist, tubal ligation reversal surgery, tubes tied, untying tubes

This entry was posted on Wednesday, April 30th, 2008 at 7:29 pm and is filed under Dr. Monteith, tubal reversal surgery, untie tubes, why tubal reversal. You can follow any responses to this entry through the RSS 2.0 feed.

1. Rhonda Brown RN Says:
   April 30th, 2008 at 7:38 pm
   

   It is truely gratifying to be a part of giving families a new start. I am sure that you will learn something new from each surgery that you are present for. I know that one amazing thing about working at Chapel Hill Tubal Reversal Center is that you learn something new either about someone else or yourself everyday.

2. Ericka Pamplin Says:
   May 1st, 2008 at 6:20 am
   

   Whatever the reason may be for choosing a tubal reversal, it is very rewarding to hear the success stories at the end of each day.

3. Stephanie Duncan RN Says:
   May 1st, 2008 at 7:01 am
   

   We are in a great profession and have wonderful jobs here at Chapel Hill Tubal Reversal Center. We love what we do!

4. SarahD Says:
   May 1st, 2008 at 7:13 am
   

   It is such a great feeling when a patient calls to inform us of their success.

5. Myrna White Says:
   May 1st, 2008 at 8:03 am
   

   Like Dr. Monteith stated it is a wonderful feeling when the surgeries go so well and the patient’s can look forward into adding to their family.

6. Julia Smith RN Says:
   May 1st, 2008 at 9:27 am
   

   It is such a pleasure to assist couples with adding children to their families. We feel honored that they chose Chapel Hill Tubal Reversal Center.

7. jgokun Says:
   May 1st, 2008 at 9:39 am
   

   I have had the opportunity to work in the O.R. several days over the past couple of weeks and have enjoyed seeing Dr. Monteith in surgery. We look forward to July 21, 2008 when he starts practicing here full time.



8. Sarah Meachem RN Says:
   May 1st, 2008 at 10:54 am
   

   I’m glad to hear that Dr. Monteith is learning a lot about tubal reversal surgery and that he enjoys meeting the patients and hearing their individual stories and reasons for wanting a tubal reversal. I can tell that he receives a lot of satisfaction from being able to help many different women achieve their goals of being able to have more children.

9. Pamela Mills CRNA Says:
   May 1st, 2008 at 10:56 am
   

   I think the miracle here is that Dr Berger has found in Dr Monteith someone who shares his passion and compassion for all of our patients who travel to Chapel Hill for the purpose of getting their tubes untied.

10. Matt Murphy ST Says:
    May 1st, 2008 at 12:09 pm
    

    I really feel great knowing that we are helping families to grow.