Tubal sterilization is one of the more common means of birth control. However later in certain conditions to attempt pregnancy another surgical procedure known as a reversal of tubal sterilization or�microsurgical tubal reanastomosis�is done.

The surgery is considerably more involved than the operation performed for the sterilization. In this procedure very thin microsuture are used to carefully put the tubes back together. It is necessary to use an operating microscope or another magnifying source to adequately visualize the anatomy and this may take from one to two hours to perform.� Reversal of tubal sterilization can be performed through a minilaparotomy incision; however, due to the length of operating time, patients usually need to spend one to two days in the hospital to recover. Patients are adviced against lifting and exercising for two weeks after surgery. Patients are allowed the normal physical activity such as driving, walking etc.

The success of this type of surgery is depends mainly upon the amount of fallopian tube remaining after the sterilization. With a length of 4 centimeters of healthy tube the chances of pregnancy� are as high as 85%. In cases where the tube has been cauterised the chances of getting pregnant after this operation may be less and in these cases, patients would more likely achieve pregnancy by undergoing In�Vitro Fertilization (IVF).

Both local and general anesthesia may be used during a tubal reversal. The procedure may be completed on an outpatient basis, although in some cases it requires a hospital admission. A tubal reversal is usually performed using one of two techniques:

• Minilaparotomy. A small incision (1 to 3 inches long) is made below the navel and the physician raises a portion of each fallopian tube to repair it

• Laparoscopy. The patient’s abdomen is inflated with gas (carbon dioxide), which helps the surgeon locate the fallopian tubes. A small incision is made below the navel and a laparoscope is inserted into the abdomen. Instruments are inserted into the same incision or a separate incision and the tubes are repaired

• Magnification and microsurgical techniques are used to repair the fallopian tubes. The ends of the tubes are cut to expose the inner, open space of the tube, called the lumen. These openings are then fused using a microscope and very fine suture material. The size of these sutures is smaller than the width of a human hair. After the tubes have been reattached, the outer covering (serosa) of tubes is sutured together over the top of the inner tube

Surgery can take anywhere from two to six hours to complete. Patients are often discharged from the hospital the following day, but the patient may need several weeks to fully recover.

Patients will generally remain in the hospital for several hours following the procedure. In some cases, a hospital stay may be required. Once discharged, patients should follow their physician’s advice in regard to any dietary, activity or medication restrictions following surgery. In most cases, recovery will take anywhere from a few days to a few weeks.

A woman can begin trying to conceive following the first menstrual period that occurs after the reversal procedure. Because women who have tubal reversals are at increased risk for ectopic pregnancy, it is important to perform a pregnancy test whenever a woman’s period is late.

If the home pregnancy test indicates a positive result, the woman should schedule a visit with her physician, who can perform a blood test to check for a hormone called�human chorionic gonadotropin (HCG)�that builds up early in a woman’s pregnancy. When this hormone reaches a determined level (1,500 milli-international units per milliliter or above), a vaginal ultrasound can be performed to look for the presence of an intrauterine gestation sac. If this sac is not present, an ectopic pregnancy is strongly suspected and the woman will require medical attention.

Potential risks with tubal reversal

• Apart from the common surgical risks others include scarring of tissue and chances of ectopic pregnancy
• There is a small chance that the tubes will become blocked again following a tubal reversal

The other Gynecology Procedures are:

• Cervical Polyps
  
• Hysterectomy
  
• Dilation And Curettage�� etc

Few Major Hospitals for Reversal of Sterilization are:

• Wockhardt Hospitals
  
• Apollo Hospitals
  
• Max Healthcare
  
• Piyavate Hospital
  
• Florence Nightingale Hospital
  

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