Tubal Reversal | Tubal Re-anastomosis | Florida Institute of Reproductive Medicine

Tubal reanastomosis is a technique used to re-approximate tubes that have been occluded. The efficacy of this technique will depend on the amount of tube and the location of the tube destroyed. If the distal portion of the tube was removed or destroyed, reanastomosis is never an option. If a cautery technique was used, often damage extends beyond the immediate cautery application site. The procedure in general is performed as an overnight hospitalization stay. Typically a mini-laparotomy incision (bikini cut) is made whereby the occluded ends of the tube can be identified and resected. Reanastomosis is performed using high magnification to allow precise alignment of tube segments. Typically the surgery takes from 1-1/2 hours to 2-1/2 hours and is performed under general anesthesia. Couples may try to conceive the following month. When considering tubal reconstructive surgery versus in vitro fertilization, it is important to realize with surgery there is an increased risk of an ectopic pregnancy, i.e. a pregnancy getting established in the tube. This may require another surgery to remove. Future contraception is also a concern. If an individual is not pregnant after four to five months, a hysterosalpingogram is generally recommended to check tube patency. If tube occlusion has occurred, in most cases IVF should be considered. Re-operating on the tubes is generally not successful. Cost to perform tubal reanastomosis ranges anywhere from $15,000 to $18.000, depending on the number of days in the hospital, as well as varying hospital charges. For the patient in her late 30s, early 40s, most patients should give strong consideration to in vitro fertilization because of potential significant delay in getting pregnant due to remaining egg number and quality. If there is a significant male factor, IVF using the ICSI technique is usually the preferable option.