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Thursday 28 June 2018

A Few Essentials On Tubal Reversal Surgery


By Karen Morris


The reproductive system is composed of the external genitalia and internal structures including the uterus, fallopian tubes and ovaries. Fallopian tubes or oviducts are a conduit for fertilized eggs to reach the womb for implantation. Some women opt to have their tubes ligated as a method of family planning. Occasionally, the tubes may be accidentally tied during pelvic operations for other reasons. Tubal reversal surgery is considered for women of reproductive age who wish to have more children.

Not every woman with ligated tubes is fit for this kind of operation. A thorough evaluation is usually needed before any major decisions are made. The doctor will ask the patient a number questions in a bid to determine their reproductive history and to establish why the process is necessary. A history of previous pelvic operations is particularly important. Such operations are necessitated by conditions such as ectopic pregnancies, pelvic inflammatory disease and even operative deliveries.

A focused physical examination is necessary in ruling out other causes of infertility such as an intact hymen or an incompetent cervix. Examination also helps to pick up any existing infections which need to be treated first before operation. Some of the priority investigations performed following physical examination include a pelvic ultrasound and a special procedure called a hysterosalpingogram (HSG). These two combined help determine the status of the oviducts in terms of length and functionality.

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.

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.

Comparable to other surgeries, reversal surgery can complicated with excessive blood loss, neighbouring soft tissue injury and infection which may develop later on. In the long run, fibrous tissue may form causing obstruction again. Ectopic pregnancies are also much more among women who have had their tubes untied.

Some of the complications encountered are preventable. For instance, simply maintaining sterile measures when treating the patient goes a long way in keeping infections at bay. In addition, prophylactic antibiotics can be given to provide cover. Patients with low blood volumes should be stabilized first before being taken to theatre to avoid the dangers of excessive bleeding.

Tubal restoration operation is a procedure that has restored the hope of many who wish to have more children after surgical contraception . However, certain factors including old age, and complications of previous surgeries reduce the chances of success. Technical errors also lower success rates. Reversal can be done directly using the open method or through the use of keyhole surgeries.




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