Laparoscopy

Many patients wish to have a previous tubal ligation reversed. Tubal reversal surgery is usually performed laparoscopically.

Laparoscopy is a surgical procedure useful for the diagnosis and treatment of infertility and pelvic pain. This operation allows a direct view of the uterus, tubes, ovaries and pelvis in general. Our Virginia fertility specialist received years of training in laparoscopic surgery.

In addition to reversal of tubal ligations, conditions such as endometriosis and pelvic adhesions are detectable only through laparoscopy. In addition to establishing a diagnosis, we offer endoscopic surgical treatment for many conditions. Specialized instruments are used and many procedures, which formerly required a major operation - we are usually able to perform endoscopically.

Tubal ligations can often be reversed laparoscopically, however, tubal ligation should still be considered a permanent means of birth control. Tubal reversal surgery should only be attempted by a highly skilled reproductive surgeon such as Doctors Williams and Bateman.

The laparoscopy for reversal of tubal sterilization requires general anesthesia and can last from 45 minutes to many hours, depending on the conditions. A small incision is made just below the naval and a special needle is inserted to inflate the abdominal cavity with carbon dioxide gas. The laparoscope is introduced through that incision. Another small incision is made in the lower midline of the abdomen for the insertion of surgical forceps and instruments to aid in visualizing the pelvic organs. If further endoscopic surgery is required, additional small incisions may be made in the lateral aspects of the lower abdomen - a total of four incisions are sometimes required. Involved endoscopic surgeries may last several hours.

The risk of complications from laparoscopy is low. As with any surgical procedure, there are risks and they include: injury to the bowel, stomach, urinary bladder, ureters, abdominal and pelvic blood vessels, ovaries and uterus. The risk of a serious complication is less than 1%. Outpatient laparoscopies are performed at the Martha Jefferson Outpatient Surgery Center (OSC).

After surgery you will be discharged with a prescription for pain medication. Most people experience minimal pain following the procedure. Nausea the evening of the procedure is a usual anesthetic side effect. By the first day following surgery you can expect mild abdominal discomfort and some discomfort in your shoulders or anterior chest. The chest and shoulder discomfort is due to irritation of the diaphragms - muscles used for breathing - and usually passes within 48 hours. You will probably have a little bit of vaginal bleeding for about 24 hours. Complete recovery to normal activity is expected within 3-4 days. Throughout your recovery you should feel progressively stronger with lessening pain. If you have worsening symptoms or have any questions about how you feel, call your doctor.