mercredi 27 juin 2018

A Few Concepts 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.

Either laparoscopy or open operation is employed during this operation. Even though it has a high learning curve, , laparoscopy enjoys the advantage of being less invasive and shorter in duration. The operation unties the ligatures and join back the tubes. The patient is put under general anaesthesia to facilitate a painless procedure.

The chances of success in the reversal operation depends on a number of factors. Studies have shown that women above the age of forty stand a lower chance of getting pregnant even after reversal surgery. Women who have several previous surgeries tend to have massive adhesions in their pelvic cavities which may result in obstruction. In addition, if there were other unsorted infertility issues, pregnancy may be difficult to achieve. Skill and experience of the surgeon is also counts a major determinant to the overall success.

Infection, blood loss and injury to other structures in the pelvic region are some of the common complications of fallopian tubal ligation reversal surgery. Ultimately, scarves tissue gets deposited in the oviducts again and blocks them. The likelihood of a fetus implanting elsewhere other than the womb is higher after reversal operation.

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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