da Vinci Robotic Microsurgical Tubal Reversal

For women who wish to have a tubal reversal, we offer state of the art Robotic Assisted Microsurgical tubal reversal using the most advanced surgical tools available today, and are able to still do this at a very affordable cost.  Without question, having a tubal reversal performed laparoscopically is associated with a much faster recovery, less pain, and less internal scarring, limiting the chance of damaging the fragile fallopian tubes.  However few surgeons are can do this procedure laparoscopically, and for those that do, because of the limitation of standard laparoscopy, sacrifices have to be made in the surgical technique compared to the older standard of having an open incision and using a surgical microscope.

By using the da Vinci Robotic system, we are able to provide you with the best of both worlds, performing a true microsurgical tubal reversal technique, while doing this as an outpatient procedure with a fast recovery and less chance of internal scarring that can affect the newly opened tubes.


How is a tubal reversal performed?

There are three methods by which a tubal reversal can be performed.  These include the old-fashioned “open” method, standard laparoscopy, and Robotic Assisted Microsurgical techniques.  In the past, patients who underwent the “open” method had a 3-4” incision in their lower abdomen to reach the uterus and tubes.  Microscopes were then used to open the tubes and sew them back together.  This method allowed precise surgery to be performed, but by using an open incision, patients had a much longer recovery, usually requiring a week or more from work.  The open incision also inherently causes scar tissue, which we just hoped did not affect the tubes.    Through laparoscopy, patient recovery is much faster, and less scarring inside occurs.  The drawback of this procedure is that due to limitations in the instruments, even the best surgeons cannot perform as precise of a tube repair as they could previously do under a microscope by hand.   This could possibly sacrifice the success of the surgery.   With the use of the da Vinci Robotic surgical system, the best of both worlds are combined, allowing a true microsurgical repair to be done, with a quick recovery and low chance of forming internal scar tissue.   Typically one small incision in the belly button (10mm wide), and three other small incisions (7mm wide) are made.   This procedure is by far the best for the patient, providing several advantages to ensure that you have the best possible outcome

Who is a good candidate for a tubal reversal?

Tubal reversal success is dependent on the method in which the tubal was first performed.   The highest success comes with those that have had “clips” or “rings” placed on the tubes.   These methods damage the tubes the least.   In some cases, a segment of tube is removed, most commonly done right after a delivery.  These methods are termed a “Pomeroy” or “Parkland” method, and in most cases are reversible.   Tubes that have been “burned” are often overly damaged and may not be reversible, though each case is different.   It is helpful to obtain a copy of the surgical operative report to better determine if a tubal reversal could be performed

Fertility is very dependent on the age of the woman.   A tubal reversal is most successful if a woman is 35 years of age or less.   For women who are over 37 years of age, studies have shown that a tubal reversal may not be the most cost effective therapy for trying to conceive.  These patients are better suited to go directly to IVF.

Is a tubal reversal covered by insurance?

In nearly all cases, insurance does not cover reversal of sterilization.    Performing a tubal reversal and trying to get insurance to cover the costs is considered insurance fraud and puts the patient and physician at legal risk.

Why don’t you perform this at an outpatient surgery center?

We only perform Robotic Assisted Microsurgical Tubal Reversals at an accredited fully staffed hospital.   Freestanding outpatient surgical centers do not offer the use of the advanced da Vinci Robotic Surgical System.  We also feel that it is the safest for patients to have surgery in a hospital.   The procedures are all very safe, but in the event that any unforeseen complications would arise, a hospital setting offers you the full resources and staff to properly care for you.   If complications occur in a surgical center, you must be transferred by an ambulance to a hospital to receive the proper care, possibly wasting valuable time.   Having your surgery performed in a hospital is always in your best interest.

friends of F.I.R.M.

We were so blessed to have the opportunity to work with Dr. Winslow and his staff at FIRM during our battle with infertility. I have never met a more kind, caring and compassionate physician than Dr. Winslow. I can honestly say that he went above and beyond to help us get our little miracle on […]

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