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Dan C. Martin, MD
UT Medical Group, Inc.

University of Tennessee Health Science Center (UTHSC)
Academic Office

Daniel Clyde Martin, M.D.
UT Medical Group, Inc.
Infertility and Gynecology
Reproductive Surgery
Germantown Office Building
7945 Wolf River Boulevard
Suite 320
Germantown, Tennessee
TN 38138-1733

(901) 347-8331
(901) 347-8188 fax
Directions to Office

Updated information is at
UTMG 2006

Click for information on:
Glenn Ann Martin, Ph.D.
Clinical Psychologist

Surgical Procedure
for Reversal of
Tubal Sterilization Operations

Surgery is performed through a small incision (2 to 3 inches depending on weight) at the hair line or using old incisions when reasonable.  A Zeiss operating microscope is used to place microscopic stitches.  The ends are connected in 2 or 3 layers depending on the area of the tube that is being prepared..  Stints have not been used since the 1970s. A specially modified retractor is used to decrease the size of the incision and prevent pressure on deep nerves.

Summary

The following pictures were taken with the Zeiss OpMi Vario S88 operating microscope.  The top picture is the actual size and the bottom picture is the appearance through the microscope.

The scar from the previous sterilization is identified.  The arrows are used in this picture to point out the limits of the scar.  The scar that is filmy and almost clear is called an adhesion.  The tube is slightly narrower than a pencil.

Actual size.

View through microscope at about 4 times normal size.

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The surface scar is removed and the closed tubal edges are identified.  The closed edges are rounded in this picture. 

Actual size.

View through microscope at about 8 times normal size.

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After the rounded scar at the edge is removed, the inside of the tube is fluffy.  If a fluffy area is not seen, the tube is cut back until a healthy area is found.  Stitches have been placed at the base.  Stitches will continue until the edges are moved immediately next to each other.  The actual size of the outside of the tube is about 0.16 inches and the inside of the edges is about 0.08 inches.

Actual Size

View through microscope at about 10 times normal size.

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At the end of surgery on the tubes, blue dye is placed through a catheter.  The catheter goes through the vagina and cervix into the uterus like the one used for a hysterosalpingogram.  Blue dye is injected into the uterus so it will flow through the tubes and be seen in surgery to prove the tubes are open.

Actual Size

View through microscope at about 4 times normal size.

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Additional tubal reversal information is available on Request.

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