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Obstertrics – Tubal Recanalisation – Laparoscopic

Home Obstertrics – Tubal Recanalisation – Laparoscopic

Introduction

Laparoscopic Tubal Recanalization is a minimally invasive procedure. The doctor recommends it to women who wish to reverse the contraception achieved through a tubal ligation procedure in the past.

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What is Laparoscopic Tubal Recanalization?

Laparoscopic Tubal Recanalization is the procedure to remove fallopian tube blockages. The doctor performs it through minimally invasive surgery with the help of a laparoscope. Doctors recommend this procedure to women who wish to reverse their tubal ligation procedure.

Tubal ligation is a method of contraception that involves blocking or cutting the fallopian tubes. Tubal ligation prevents the egg from reaching the sperm, thereby preventing pregnancy. Laparoscopic Tubal Recanalization reconnects the cut or blocked parts. Successful Tubal Recanalization is possible in women who suffered minimal damage to their fallopian tubes during ligation.

What are Fallopian Tubes and Their Functions?

Fallopian tubes are part of the female reproductive system. The tubes extend laterally from the uterus to the ovaries. A tube is about 11-12 cm long. Anatomically, a tube consists of different parts. These are fimbriae, infundibulum, ampulla, and isthmus.

The fallopian tube has several functions. The inner layer provides nutrition to the eggs, while the muscular layer contracts and assists in egg movement.

Why Does the Doctor Perform Laparoscopic Tube Recanalization?

The doctor recommends Laparoscopic Tube Recanalization to reverse the contraception attained after tubal ligation.

There are several reasons for Tubal Recanalization. The doctor performs the procedure when women undergo tubal ligation without proper counseling and regret their decision later. Other more common and valid reasons for tubal recanalization include the loss of a child in an accident or a woman’s remarriage due to divorce or the death of her husband.

Which are the Patients Suitable for Laparoscopic Tubal Recanalization?

Not all women are eligible for Laparoscopic Tubal Recanalization. The doctor comprehensively examines a woman’s health on several parameters and then decides if the procedure can be performed. Some parameters include:

  • Tubal sterilization method: The type of procedure used during tubal sterilization plays a crucial role in its reversal. Using rings and clips during tubal sterilization may result in a successful tubal recanalization. However, methods such as electrocautery, Adiana system, or Essure technique are not reversible.
  • Damage to the fallopian tube: Women with significant damage to their fallopian tubes during tubal sterilization have fewer chances of successful tubal recanalization.
  • Body mass index: Overweight or obese women have lower chances of successful tubal recanalization.
  • Age: Younger women have a high chance of getting pregnant after tubal recanalization.
  • Underlying medical problems: Some underlying medical problems reduce women’s chances of getting pregnant after Tubal Recanalization. These include autoimmune diseases and diseases affecting fertility.

How Do Doctors Perform Laparoscopic Tubal Recanalization?

You may be under general anesthesia during the procedure. The surgeon makes a small cut on the abdomen and infuses carbon dioxide to raise the pelvic region. The doctor, through the incision, inserts the laparoscope to view the fallopian tube. The doctor then removes the damaged section, if any, and reattaches the fallopian tube. The entire procedure takes around 2-3 hours.

What are the Risks of Laparoscopic Tubal Recanalization?

Laparoscopic Tubal Recanalization is a minimally invasive procedure. It has fewer complications than open surgery. However, like any other laparoscopic surgery, laparoscopic tubal recanalization has the following risks:

  • Trauma to nearby organs: While recanalizing the fallopian tubes, there may be damage to nearby organs.
  • Bleeding: Bleeding may occur due to injury to the nearby blood vessels.
  • Anesthesia complications: The patient may sometimes experience complications due to general anesthesia. These are dizziness, difficulty urinating, nausea and vomiting, breathing problems, and alteration in cardiovascular parameters.
  • Infections: As laparoscopic surgery involves internal tissue exposure, there is an infection risk.
  • Unsuccessful pregnancy after surgery: The reason for tubal recanalization is to regain fertility. However, sometimes, women fail to get pregnant.
  • Fallopian tube scarring: Tubal Recanalization may result in scarring of the fallopian tubes. It may result in infertility.
  • Ectopic pregnancy: The rate of ectopic pregnancy in women with tubal reversal surgery is around three to eight percent. Ectopic pregnancy is a life-threatening condition and requires immediate medical intervention.

When to Consult the Doctor After the Procedure?

Laparoscopic Tubal Recanalization is a safe and effective procedure. However, there may be some side effects after you are discharged from the hospital. Consult your doctor if:

  • ● You experience nausea, vomiting, and dizziness
  • ● Abdominal swelling does not go away
  • ● You have persistent abdominal cramps
  • ● You experience a gassy and bloated feeling

What is the Recovery Period Laparoscopic Tubal Recanalization?

Doctors discharge patients within one day after the procedure. Patients may resume their routine activities within three days after the procedure. They may remove the bandages after three days and can engage in sexual intercourse after one week.

Women may also experience bleeding for a few days. They should consult their doctors in case of significant blood loss.

Women may expect to have regular periods within six weeks post-surgery. During the initial few periods, women may experience heavy bleeding, pain, and discomfort.

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FAQ's

Does the Patient Feel Pain During or After Laparoscopic Tubal Recanalization?

Doctors perform the procedure under general anesthesia. Thus, there is no pain during the surgery. However, some patients may feel mild to moderate pain post-surgery. Doctors prescribe medicines to manage such pain.

What are the Advantages of Laparoscopic Tubal Recanalization?

Laparoscopic surgery offers several advantages. These include fast recovery, lesser hospitalization days, minimum complications, and small incisions.

What are the Options for Achieving Pregnancy Other than Laparoscopic Tubal Recanalization?

Due to various reasons, Tubal Recanalization may not be an option for some women to restore their fertility and get pregnant. For such women, in-vitro fertilization (IVF) is another possible option.

What is the Rate of Successful Pregnancy After Laparoscopic Tubal Recanalization?

Approximately 50 to 80 percent of women achieve pregnancy after Tubal Recanalization. However, it depends on various factors, including their partner’s sperm count and quality, age, sterilization methods, and health of the fallopian tubes.

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