Recanalization – Tubal

In India, sterilization is an everyday procedure. Indian population control measures are rigouressly implemented through female sterilization.

It is an important constituent of National Family Planning Programme in India.  there is a cash insentive for female sterilazation. There are government set targets and eager officials to see the numbers are maintained month after month.

However due to unforeseen circumstances, 1-3% of these women subsequently demand reversal of sterilization. This has been time honored request but the results are not improving with the introduction of microsurgical tubal surgery. There is incrreased likelihood of marked improvement in pregnancy rates now adays.

Technique

Tubal microsurgery is performed under general or spinal anesthesia. Principles of microsurgery are meticulously followed.

The occluded segment of the tube is resected till there was complete excision of pathological tissue( previously operated segment). Precise alignment of tissue planes using atraumatic technique is carried out with thin prolene (monofilament polypropylene) 8-0 size ( very small) .

For end to end tubal anastomosis, four sutures at 12′, 6′, 3′ and 9-O clock are taken round the tube. Final length of the reconstructed oviduct was measured on each side and noted and ideally should be more than 5 cm.

The discrepancy in luminal diameter is tackled by enlarging the narrower segment by giving a 2-3 mm cut with scissors at its antimesosalpingeal border.

Sexual intercourse is allowed as early as possible after surgery.