In the first part of this article on tubal reversal surgery, we discussed how the world renown tubal reversal doctor, Dr. Gary Berger of Chapel Hill Tubal Reversal Center, performs this procedure. We are doing this in order to give you an inside peek, so to speak, into what happens during the operation. In the first part, we discussed the tenants of microsurgery that Dr. Berger follows to minimize trauma and bleeding in order to ensure a rapid recovery. We also discussed what happens along the way to getting to the abdominal cavity where the uterus and fallopian tubes lie. Please review that first part.
Before beginning any work on your fallopian tubes, Dr. Berger will wash them down with more anesthesia from a syringe. Another step to minimize trauma. Now the important work begins. Using some special scissors called iris scissors as they are used in delicate eye surgeries, he will cut away the bad portions of your tube that is nearest the ovary. Now, using a special Winston probe, named after the doctor you first did the tubal reversal surgery, Dr. Berger will thread a stent through that section of fallopian tube. This is done with special suture material and to ensure that your tube is actually open with no internal blockage.
Moving to the other piece of your fallopian tube, he will remove the other damaged part opening the tube once again. He threads the stent into this piece and on into the uterus to again be sure of no more blockage. Putting the two freshly cut ends of tube together, he adds a few stitches from them into the tissue underneath. This is done in order to provide support and lessen the strain on the tubes as they heal. They won’t have to rely on only the stitches in your tubes to hole them together.
In case you were curious, the suturing material used is the same kind as used in heart surgeries. It has anti-inflammatory properties and lessens the risk of scarring. This will keep the swelling down around the stitches.
If you are wondering why you want little scarring in your tubes as possible, you have to know a little about the innermost layer of the fallopian tube. It is lined with cilia that help move the egg along to the uterus. Scarring means no cilia or damaged cilia which can increase your risk of an ectopic pregnancy. We sure don’t want that. That goes on to explain why Dr. Berger only sutures the two outer layers of the fallopian tube and does not stitch through the innermost layer.
Now that the tube has been sutured together, Dr. Berger will remove the stent from the fimbrial end of the tube. That’s the end nearest the ovary that catches the egg as it is released from the ovary. Now the doctor will fix the other tube in the same manner and then begin the process of closing you back up. He sutures as needed as he backs out.
Maybe you remember from the first part of this article talking about how he cut between two muscles instead of slicing through them. He actually sutures these two muscles together to minimize your risk of developing a hernia. And to keep the tension low on the sutures at the skin layer, he will suture the fine fascia layer just below the skin. In another effort to lower your pain after surgery, he will give you a hypogastric nerve block as well.
As a last step in mitigating pain, the patient will be given a TENS unit, transcutaneous electrical nerve stimulator, which stimulates the body at the point of the incision to release endorphins to help with the pain. This just goes to show the extent of what Dr. Gary Berger does both during and after a tubal reversal surgery to help you to recovery faster.
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