DGO, MS, Fellowship in Gynaecological Lap Surgery (Sydney -Australia)
Consultant Gynaecologist & Obstetrician
Infertility Specialist & Lapaoscopic Surgeon
by Dr. Sankar Dasmahapatra
Laparoscopic tubal ligation is one of the most common and effective way of birth control but at times patients want to reverse the process – in medical language it is called laparoscopic tubal recanalization surgery. After successful recanalization patients can try for conception from next menstrual cycle. Fertility outcomes are favourable.
As per our processes we study patient’s case thoroughly, both medical and demographically and we discourage patients under the age of 30 years to go through permanent birth control measures.
Background -
Infertility is defined as a disease characterized by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse in a woman under age 35, or after 6 months in a woman over the age of 35 .Infertility is a common problem throughout the world. It is estimated that more than 186 million people suffer from infertility, the majority being residents of developing countries. Infertility may be primary or secondary. Primary infertility is defined as a woman who has never had a clinical pregnancy. Secondary infertility is the inability to establish a clinical pregnancy but the woman has previously been diagnosed with a. clinical pregnancy. There are both male and female causes for infertility with the most common causes of female infertility being ovulatory dysfunction and tubal disease. Tubal infertility is estimated to account for between 11 and 67% of infertility diagnoses. Tubal infertility can be caused by internal blockage of the fallopian tubes, abnormalities of the internal tube from inflammation or infection, or pelvic adhesions which prevents normal functioning of the fallopian tubes. The blockage of the fallopian tubes may be proximal, in which case, the blockage is commonly composed of debris which forms a plug in the proximal tube. If the blockage is more distal, then the cause is usually previous infection, which may present as a hydrosalpinx with dilatation of the fallopian tube, and no spill from the tube on hysterosalpingogram (HSG). If the fallopian tube is blocked proximally, then selective recanalization of the tubes may be effective in opening the fallopian tube allowing for potential fertility.
What is laparoscopic tubal Recanalization?
The procedure aims at reconnecting the previously cut portions of the fallopian tube. After family planning some women want to reverse the procedure, which created a break in the fallopian tube. The reverse procedure involves reconnecting the fallopian tubes in order to become fertile again.
Laparoscopic tubal recanalization is highly skillful surgery in which fallopian tubes are repaired using very thin suture material (Thread) –As thin as hair of an eyebrow.
We use smaller 3 mm size instruments to conduct the procedure. The segment of the fallopian tube where previous ligation was done is cut so as to get fresh and healthy tube with lumen inside and both the cut ends are sutured together so as to get hollow lumen in continuity with each other.
Advantages Of Laparoscopic Tubal Recanalization Includes
Laparoscopic Tubal recanalization is safe, less painful. Patient recovery is very fast as compared to traditional Tubal recanalization. Patient can be discharged practically on very next day of the surgery.
Laparoscopic tubal recanalization has many advantages over open operation. The principal advantage of laparoscopic tubal recanalization is no big cut is made on the skin, which would result in minimal scarring. The procedure requires only minimal tissue handling, so less postoperative adhesions. The smaller incisions will also aid speedy recovery post surgery. Scope of complications is kept minimal. In most cases, patients will be able to leave the hospital post procedure within hours after having the procedure.
What is the success rate of laparoscopic tubal Recanalization?
Previous studies have reported the safety and usefulness of tubal recanalization. A meta-analysis of studies in patients undergoing FTR for bilateral tube blockage showed an 85–95% success rate in overcoming the obstruction, leading to a conception rate of 50%.
Is laparoscopy good for conceiving?
Will a laparoscopy hurt my chances of getting pregnant? For some women, who have undergone a laparoscopy to remove fibroids or endometriotic lesions, repair a hydrosalpinx, unblock a fallopian tube, or reverse a tubal ligation, the surgery actually increases the chances of getting pregnant.
What is the success rate of Recanalization surgery?
Interventional tubal recanalization or fallopian tube recanalization (FTR) is an extremely effective procedure for treating proximal tubal obstruction with a technical success rate as high as 90%.
Can a woman get pregnant after Recanalization?
This procedure successfully unblocks one or both tubes in up to 90% of patients. Intrauterine pregnancy after successful recanalization occurs in 30-50%, with most pregnancies occurring in the first three to six months after the procedure.
Is fallopian tube Recanalization painful?
There should be no lingering pain or other unpleasant sensation.
How successful is laparoscopy to unblock fallopian tubes?
The success rate of this method can be up to 85%; Laparoscopic surgery to remove adhesions of fallopian tubes and fallopian tubes: For cases where the fallopian tubes are attached due to inflammation, which can easily lead to ectopic pregnancy, the patient needs to undergo surgical dilation and removal of the fallopian ...
Is Recanalization good?
The proportion of patients with good general functioning was significantly higher among those with successful recanalization: 64.3% of patients with successful recanalization showed good general functioning at 24 weeks, compared to 42.9% of those without recanalization.
When is fallopian tube Recanalization?
A tubal recanalization procedure begins with an HSG. The patient should be scheduled usually within 5–11 days of her menstrual cycle in the follicular phase of her cycle prior to ovulation.
Can laparoscopic surgery unblock fallopian tubes?
Laparoscopic or hysteroscopic surgery to repair the Fallopian tubes. These minimally invasive procedures can repair blocked Fallopian tubes. A laparoscopy involves a small telescope being inserted through a small incision in the patient's belly button. The recovery time for this treatment is usually two to three days.
How quickly can Recanalization occur?
Studies have shown that early recanalization usually occurs between 2 and 6 weeks post-vasectomy.
What is the purpose of Recanalization?
This process facilitates clot lysis and continually improves residual flow until the clot breaks up under the pressure of arterial blood pulsations. Recanalization time may be an important clinical parameter of thrombolysis.
Can you get pregnant after laparoscopic tubal?
Tubal ligation is one of the most effective ways to prevent pregnancy, with rates of pregnancy around 1/1,000 after the first year, and between 2-10/1,000 after five years. Although the possibility of becoming pregnant is low, the chance is still there.
What is the recovery time for fallopian tube Recanalization?
If a blockage is identified, the doctor will attempt to open the blockage by inserting a small, soft catheter through the blockage. The entire procedure typically lasts only 30 minutes, patients go home the same day, and there is little to no recovery time needed.
He is one of the finest Laparoscopic Surgeon to do Laparoscopic tubal recanalization.