A tubal reversal is a procedure to reconnect the fallopian tubes in a woman who has previously undergone surgical sterilization, known as tubal ligation. In a tubal reversal operation, the surgeon removes the portion of each fallopian tube that has been blocked or cut. Once the damaged portion has been removed, the tubes are reconnected to form a complete, open fallopian tube. The fallopian tubes are the passageway through which the released eggs travel and meet with a man's sperm and become fertilized.

A tubal reversal, also known as tubal reanastomosis, is usually performed when a woman wants to try to achieve pregnancy after undergoing a tubal ligation. In many cases, surgery for tubal reversal is successful. However, a number of factors can affect the success of the procedure. Estimates vary, but health experts approximate somewhere between 50 to 75 percent of tubal reversals are successful in reopening the fallopian tubes. However, the success rate may be much lower.

?Adequate tubal segments remaining

?No other significant fertility problems such as non-viable eggs or ovulation dysfunction

?A partner whose sperm analysis is normal

A woman considering a tubal reversal must first determine if she is eligible for the procedure. In some cases, the initial sterilization may have prevented any hope of reversal. For example, a sterilization technique known as fimbriectomy involves removal of the end of the fallopian tube. This type of sterilization generally cannot be reversed. In addition, reversal may be difficult if sterilization was achieved through cauterization (using electric heat). This type of sterilization may damage more of the fallopian tubes, resulting in a greater difficulty with reconnection.

?Minilaparotomy. A small incision (1 to 3 inches long) is made below the navel and the physician raises a portion of each fallopian tube to repair it.

?Laparoscopy. The patient's abdomen is inflated with gas (carbon dioxide), which helps the surgeon locate the fallopian tubes. A small incision is made below the navel, and a laparoscope is inserted into the abdomen. Instruments are inserted into the same incision or a separate incision and the tubes are repaired.

Magnification and microsurgical techniques are used to repair the fallopian tubes. The ends of the tubes are cut to expose the inner, open space of the tube, called the lumen. These openings are then fused using a microscope and very fine suture material. The size of these sutures is smaller than the width of a human hair. After the tubes have been reattached, the outer covering (serosa) of tubes is sutured together over the top of the inner tube.