Welcome to the tubal reversal web page of The Jackson Clinic. My name is Dr. Lisa Rogers, and I have been practicing obstetrics and gynecology in Jackson, Tennessee since 1991. In January of 1997, I began learning the procedure of tubal anastamosis under the direct guidance of Dr. John Curlin. I operated with him on a regular basis for several years, and I use exactly the same sutures and techniques that have been so successful in his hands. I have also operated with surgeons in Nashville, Tennessee and Jackson, Mississippi where I observed a variety of methods of tubal reversal surgery. I am now performing these procedures on my own patients. You can read comments from patients that have become pregnant following a tubal reversal procedure.
Here is some information regarding:
The tubal reversal operation
Factors affecting pregnancy rates after tubal reversal
Precautions regarding tubal reversal
Who is a candidate for tubal reversal
Our cost and procedures for tubal reversal
The tubal reversal operation:
The tubal reversal operation, also called tubal anastamosis or reanastamosis, is a surgical procedure done to reconnect a woman's fallopian tubes after a tubal ligation. The fallopian tubes are repaired with the use of an operating microscope at 10 times or greater magnification. Special micro-instruments and sutures allow the tube to be freed from its scar and adhesions and then sewn together to restore patency of the severed ends.
The tubal repair is performed in two layers, using 8-0 Vicryl suture. Patency of the fallopian tubes is verified by passage of blue dye injected through the cervix of the uterus at the time of surgery.
Operating time varies from 90 to 120 minutes, and the hospital stay varies from 12 to 24 hours. The procedure is usually without complications, with the exception of pain and occasional postoperative nausea.
The incision is closed with sutures that will dissolve by themselves, so there is no need for staples or stitches to be removed. The sutures will be covered with a surgical dressing that looks like Saran Wrap; this should be removed seven days after surgery (sooner if it appears to be irritating the skin). The majority or patients are able to return to work in two weeks. Most patients have not had any problems traveling within 24 to 48 hours of their surgery. After the surgery is done, you will spend about an hour in the recovery room, and then will go to a private room. When you are able to eat or drink a little bit, and urinate, you will be allowed to leave the hospital. I prefer that you not leave Jackson until the day after surgery. If you are nauseated or have pain that is not relieved by pain medicine taken by mouth, you may stay in the hospital overnight. You will be given a prescription for pain medication (for post-operative use) on the day that you come in the office for your preoperative visit. This is not covered in the $4500 cost; the generic form of pain medication usually is about $20-$30.
Factors affecting success of tubal reversal:
There are several factors to consider in the success of tubal reversal surgery. The fallopian tube functions to pick up an egg after it has been released from the ovary, and then provides the place where the egg and sperm join. The tube then helps to move the fertilized egg into the uterus, or womb, where it can implant and grow.
For a tubal reversal to be possible, the fimbria of the tube must still be present. The fimbria is the end of the tube near the ovary that resembles a flower, and helps to pick up the egg after it is released; this is one of the reasons why I request the reports from your tubal ligation surgery. These reports include the operative and pathology reports. If these indicate that the fimbria has been removed, there is no way to restore the function of the fallopian tube.
Precautions regarding tubal reversal:
Even if the tubal reversal surgery goes perfectly well, and the tube is open all the way through, there is no guarantee that the tube will work correctly. The fallopian tube has tiny hair-like cells called cilia that help to move the fertilized egg into the uterus. There is no way to control the function of the cilia at the time of surgery. Smoking does decrease the ability of the cilia to work correctly, as well as decreasing fertility rates in general.
One very important fact to consider after a tubal reversal procedure is the increased risk of ectopic, or tubal pregnancy. After a tubal ligation and then tubal reversal, the tube has been operated on twice and scar tissue can form that keeps the fertilized egg from moving through the tube correctly. It is mandatory that you seek early prenatal care from your local OB-GYN doctor as soon as you think you might be pregnant. You will need to have blood tests and ultrasound(s) done to be sure that your baby is growing in your uterus. I also recommend that you take folic acid, or folate, 0.4-1.0 mg (400-1000 mcg) daily. This has been proven to lower the chance of your baby having a neural tube defect, or spina bifida. It is important that you start this before you get pregnant to gain the benefit.
Patients who are severely overweight are very difficult to operate on -- the thickness of the abdominal wall interferes with surgery because the micro-instruments are not long enough to properly repair the tube. I am unable to operate on anyone with significant obesity. Please include your height and weight with your letter of introduction. If your weight is questionable according to standard insurance tables, I may ask for pictures of you in your underwear or bathing suit from front and side view to see if the surgery can be done.
Patients who have a latex allergy are inoperable.
There is a chance of complications with any type of surgery, although the risk associated with tubal reversals is low. Risks of surgery include bleeding, infection, and damage to internal organs such as the bowel, bladder, ureters (the tubes that carry urine from the kidneys to the bladder), nerves, and blood vessels. There can also be a reaction to the medication used for anesthesia. If bleeding is excessive, a blood transfusion may be necessary. In extremely rare cases, death could occur as a result of a surgical complication. These are all things that you need to be aware of, but remember that tubal reversal surgery is associated with a low risk of complications. If you have any questions about this, please do not hesitate to ask, either by e-mail or when you come in for your pre-operative visit.
Who is a candidate for tubal reversal:
If you are interested in pursuing this procedure, please mail or fax a copy of your operative notes concerning your tubal ligation and also a copy of the pathology report. You may send these to Dr. Lisa Rogers, 2863 Hwy. 45 Bypass, Jackson, TN 38305; fax (731)-660-8301. Please also include a letter of introduction.
You will receive a letter stating my opinion concerning your candidacy for the reversal surgery following receipt of this information. My nurse, Cindy Rawdon, will be happy to answer further questions and schedule your surgery if you so desire. Surgery is usually scheduled 7 to 14 days after the first day of your menstrual period, but this can be altered to suit the needs of the patient. We try not to schedule during the menses. Our phone number is (731) 660-8300.
Patients who fly from distant sites typically use the Nashville or Memphis airports. Nashville is often less expensive. My office is approximately 2 hours and 15 minutes from the Nashville airport and 1-1/2 hours from the Memphis airport. Both are accessible to Jackson via Interstate 40.
The Doubletree, which is conveniently located to The Jackson Clinic and the hospital offers discounted rates for out-of-town patients. Please call 731.664.6900 for more information on rates and availability.
As a rule, patients arrive before 3:00 pm the day prior to surgery for their preoperative evaluation and then go to the Jackson-Madison County General Hospital to take care of preadmission procedures. The day of surgery, they arrive early in the morning. Surgery is done usually in the morning, and patients are discharged either late afternoon or evening of the day of surgery or the next morning.
Our cost and procedures for tubal reversal:
The cost of surgery and anesthesia fee is $1,800.00 payable to The Jackson Clinic; the cost of the hospital fee is $2700 payable to the Jackson-Madison County General Hospital, for a total of $4500.00. This does not include travel costs, lodging, or your prescription pain medication. A non-refundable $1000 deposit is required to schedule your surgery and the remaining balance is due on the day prior to surgery. The deposit should be payable to The Jackson Clinic. We do not accept personal checks. The hospital fee can be paid at the time of your pre-admission visit, usually also on the day prior to your surgery. When you pay the deposit and your surgery is scheduled, an account will be opened for you at The Jackson Clinic and you will receive a written receipt.
The overall fee is as inexpensive as possible and is maintained at this level in order to allow as many patients as are interested to reverse their tubal ligation.
Prior to surgery, all correspondence will be in the form of letters. If you have any special concerns, the hotline number is (731) 660-8300.
Telephone: (731) 664-1375
Fax: (731) 660-8301
Map to Jackson Clinic North Campus
Read comments from patients