Anaesthesia
My anaesthetic and surgical nursing staff are highly experienced and together they have been performing reversals for many years. A light general anaesthetic is given and throughout your reversal your heart rate, blood pressure, breathing, and oxygen level are continually monitored to insure your safety.
Laparoscopically assisted microsurgical technique
My surgical team and I have developed a highly advanced laparoscopically assisted method of microsurgery which has all the accuracy of microsurgery and the benefits of small incisions from laparoscopic methods.
Using his method a laparoscopy is usually performed immediately prior to tubal reversal to ensure that there is not irreparable damage to your Fallopian Tubes. This involves a thin telescopic instrument (7mm diameter) being inserted through a 1cm incision in the umbilicus (navel) to examine the internal organs of the pelvis. The organs are separated by introducing gas (carbon dioxide) via the laparoscope. Most of the gas is removed at the end of the procedure, and any remaining is absorbed harmlessly by the body. The uterus and fallopian tubes to be moved into position immediately beneath a second incision of 3cm to 4cm in the pubic hair line through which the microsurgical reanastomosis is performed. A supporting stitch is then placed through the ligaments if the ovary to keep the Fallopian Tube (to which it is attached) in position. If necessary the tube (on each side) is then dissected free of the surrounding tissue. The area of the prior tubal ligation it is then cut on either side so that a normal open tube is available for reanastomosis of each end.
Microsurgical reanastomosis
Once the cut ends of the Fallopian Tube are in close proximity with each other and stabilized in position an operating microscope is then used to magnify the site of the microsurgery approximately 40 times. A series of very fine microscopic sutures (less than the diameter of a human hair) are then placed around the circumference of the lumen of the Fallopian (which is less in diameter of a pin) to bring the ends together and establish patency. A second layer of sutures is then added to provide support and stability to the site of the anastomosis.
Skin Closure
Upon completion of the microsurgery the two small skin incisions are closed with very fine invisible stitches beneath the skin. Rarely, a subcutaneous drain or an indwelling urinary catheter are left in place for a short time after the operation.