Dr. Pabon’s Method of Tubal Ligation Reversal
1. Your procedure will usually begin with Dr. Pabon making a small "bikini" incision just above the pubic bone. Dr. Pabon enters the inner abdominal sac within only minutes of the initial incision.
2. Gentle traction is used to elevate the womb and the fallopian tubes so they can be easily handled and repaired. Great care is taken to keep all tissues moist throughout the procedure.
3. Dr. Pabon identifies the fallopian tubes and determines where they are blocked. The scarred and blocked part of the tubes is then removed and small bleeding points are controlled using a micro-bipolar electrical instrument. The open tubes are checked for patency using a micro-lacrimal probe or a special blue dye. This confirms that the tube is open to the womb and to the fimbrial end.
4. The open ends of the tube are then brought together with a suture that is the same size as is used to repair coronary arteries in the heart (6-0). This suture is placed just under the open ends in order to bring the open ends closer together and remove tension from the anastomosis. The lumen and muscle walls of the fallopian tube are brought together with four 8-0 or 9-0 sutures. This size of sutures are also used by eye surgeons in corneal surgeries.
5. Four or more 8-0 or 9-0 sutures are used in this inner layer depending on the size of the tube. Then 8-0 suture is used to bring together the outer layer of the anastomosis.
6. Local anesthesia is placed on the tubes and in all the layers of the abdomen. The anesthesia team is extremely focused and highly trained in outpatient surgery which usually allows for patient discharge within two hours post-surgery.
Because of the sophistication of our surgical techniques, many of our out of town patients ask if they can leave the Sarasota area the same day of surgery. Although there has never been a serious complication, departure from the city is not advised. It is wise to remain near your surgeon for at least two days in case follow-up is required.
In the very rare event of a complication, all out- of-town patients are required to have an established relationship with an Ob/Gyn specialist. Our program has enjoyed tubal patency rates of over 90%, pregnancy rates over 50-60%, while having a rate of ectopic or tubal pregnancies less than 2%. In the past, the only surgery related complication for patients has been a rare incision infection-typically seen in one person every 2 - 3 years. These incision infections usually respond to oral antibiotics but sometimes the outer part of the incision has to be opened and allowed to heal slowly with dressing changes. Incision infections tend to occur in more obese patients.
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