Outpatient Procedure

Outpatient Surgery for Tubal Reversals

Maximum of two procedures performed a day for the best patient results.

We know you have many questions and we encourage you to ask and become as informed as possible. See frequently asked about tubal reversals.

“10 percent of women who have had a tubal sterilization procedure would get it reversed if it was safe and affordable.”

Each year, more than 700,000 women undergo a tubal ligation in the United States. This surgery is considered permanent, but thanks to advances in modern medicine with microscopic tubal reversal, many women can have this reversed and conceive again.

Tubal reversal is considered the most effective way to become pregnant after a tubal ligation. Compared to IVF (in vitro fertilization), tubal reversal is only a fraction of the cost. One tubal reversal surgery can produce multiple sequential pregnancies unlike IVF that requires expensive sessions with each attempt at pregnancy.

We are happy to say, a tubal reversal is extremely safe, affordable and essentially pain free. We know everyone worries about pain after surgery and may even avoid surgery because of this fear. That’s why we use the revolutionary Exparel injection, a numbing agent for pain relief. It makes recovery after tubal reversal surgery essentially pain-free.

About the Procedure

Explaining Tubal Reversal Surgery

illustration of a tubal reversal where a doctor creates a reconnection of fallopian tubesThe tubal reversal operation, also called tubal ligation reversal, or tubal reanastamosis, is performed microscopically to reconnect a woman’s fallopian tubes after a tubal ligation.

In all types of tubal ligation, both ends of the tube are blocked and a small piece of the tube is missing. Once Dr. Rosenfeld reads your operative report, he’ll know how much of your tube remains and seems to be healthy for the tubal reversal surgery. The average length of tube before sterilization is 12-13 cm. As long as there is at least 4 cm of healthy tube remaining, this should give you the very best chance but we’ve had success with only 3 cm of tube

Dr. Rosenfeld has perfected his technique over the past 30 years of performing tubal reversals. He is very proud of his refined technique and his excellent success rate reflects his attention to detail and meticulous, precise approach.

The tubal reversal surgery is performed through a mini-laparotomy incision of 2″ located at the hair line just above the pubic area. The tubes are repaired using a multi-layer technique, which experts agree is the most effective way to repair the tubes.

Dr. Rosenfeld performs the tubal reversal surgery using the most expensive sutures available and most commonly used in delicate eye surgery. The ultra-fine 10-0 nylon suture is the smallest, finest suture available, which reduces the amount of scar tissue that may develop. It has the smallest needle for decreased trauma to the tissues. These ultra-fine sutures require a high degree of technical skill and years of experience but we have found our tubal reversal success rates have increased significantly since using these sutures.

A hysteroscope is routinely used during the tubal reversal surgery to view the inside of the uterus. This enables Dr. Rosenfeld to identify and remove fibroids or polyps which affect 20-50% of women of reproductive age and all this is done without any increase in cost. These fibroids can impair fertility and cause gynecological problems in the future.

Another essential detail in Dr. Rosenfeld’s tubal reversal surgery is the use of Gynecare Interceed approved by the FDA to help prevent adhesions. Adhesions can happen with any surgery and can decrease the chances for a successful pregnancy.

dr rosenfeld performs a hsg dye test at end of tubal reversal procedureOnce the Fallopian tubes are reconnected, a dye is injected through the cervix to confirm that the tubes are no longer blocked and they are water tight, indicating a successful surgery. This is never rushed and always performed with exact precision. Dr. Rosenfeld won’t stop until he is 100% satisfied with the flow of the dye in the tube. He has an intense drive for surgical perfection and wants your tubal reversal surgery to be as successful as possible.

The entire tubal reversal procedure usually takes approximately two hours. You will be discharged from the outpatient surgery center within two to four hours and can expect to resume normal activities within a week, depending on the physical nature of your job. All of our tubal reversals are performed in a new state-of-the-art outpatient hospital and surgery center connected to a state-of-the-art hospital.

To help you recover from tubal reversal surgery as quickly and pain-free as possible, we offer the Exparel numbing anesthetic. It’s a revolutionary method of pain management that enables you to recover comfortably, providing continual and targeted pain relief directly where you need it. Our tubal reversal patients using this method have almost immediate ambulation which decreases the risk for post- operative problems. As we all know, after dental work, the pain starts once the local anesthetic wears off. The injection provides pain relief for three days, keeping the area numb and free from pain.

Getting Started

Dr. Rosenfeld reviews your medical records including your tubal ligation operative report from the hospital where your tubes were tied. He also reviews fertility parameters such as age and BMI for your tubal reversal assessment. to determine if you are a candidate for the tubal reversal surgery.

After his review, we call you to schedule your free appointment. You can choose if you want to come to our office or have a phone consultation to find out if you are a candidate for tubal reversal.

If Dr. Rosenfeld feels you would have a higher success rate with IVF over tubal reversal, he will recommend the best IVF center in your area. He will be 100% honest with you because his goal is for you to have a baby.

Once it is determined that you are a candidate for the tubal reversal surgery, our staff will arrange your surgery at the First Street Surgical Center.

The scheduling coordinator from the surgical center will call you prior to your surgery to obtain information necessary to complete your medical records. (Download the First Street Surgical Center information packet here.)

The admitting nurse from the surgery center will also speak with you prior to your surgery to complete a History and Physical and review pre-operative instructions. Please take this opportunity to ask any questions you have concerning the facility or your surgery.

Office Visit – Day Before Surgery

Dr. Bernard Rosenfeld and his staffYour office visit with our staff will last approximately two hours. At this visit, you will receive detailed information regarding surgery and review all medical information.

Other aspects of this visit:

  • Full physical examination
  • Pelvic ultrasound (While included in your fee, the average cost for a pelvic ultrasound is $200. If this ultrasound reveals conditions such as common fibroids or abnormal ovarian cysts which can cause fertility problems, they will be removed at the time of surgery at no additional cost.)
  • All pre- and post-surgery medications are provided – pain, anxiety-sleep, non-steroidal for soreness, nausea, pre-operative bath soap
  • Post-operative and wound care instruction
  • Ovulation education, menstrual history

You will receive your post-surgery pain medications before leaving the surgical center because we want you to be as comfortable and pain-free as possible. In fact, the nurses in the hospital refer to Dr. Rosenfeld as “No Pain Rosenfeld.”

Tubal Reversal Medications Included

Typically you will receive the following medications:

1. Day Pro for pain and swelling – similar to Motrin (ibuprofen) but lasts 24 hours

2. Tylenol #3 for pain

3. Ativan for anxiety

4. Phenergan for nausea

Day of Surgery

Arrive at First Street Surgical Center at your appointed time. You will meet the anesthesiologist and have blood drawn. General anesthesia is used to put you to sleep for the surgery.

The surgery lasts approximately two hours. After leaving the surgery suite, you will be moved to a post-op recovery area where nurses will care for you until you are awake and comfortable.

Once awake, you will be transferred to a recovery area where your family member or friend may join you. As soon as your condition is stable and you have a responsible adult to drive you home, you will be discharged. Make arrangements in advance for your transportation home or to your hotel if you are from outside the Houston area.

Out of Town Patients

For patients who live outside the Houston area, we offer recommendations for local hotels for our tubal reversal patients. After post-op recovery, you will be discharged in the afternoon with your family member or friend so you can return to your hotel.

Most patients are able to travel home the day after their surgery.

Week After Surgery

About a week after surgery, patients should return to see Dr. Rosenfeld in his office or visit with their local doctors for removal of the wound dressing and to assess health and healing progress of the incision.

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