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In the first part of this article on tubal reversal surgery, we discussed how the world renown tubal reversal doctor, Dr. Gary Berger of Chapel Hill Tubal Reversal Center, performs this procedure. We are doing this in order to give you an inside peek, so to speak, into what happens during the operation. In the first part, we discussed the tenants of microsurgery that Dr. Berger follows to minimize trauma and bleeding in order to ensure a rapid recovery. We also discussed what happens along the way to getting to the abdominal cavity where the uterus and fallopian tubes lie. Please review that first part.

Before beginning any work on the fallopian tubes, the surgeon washes it with more anesthesia. Using iris scissors, special scissors used in delicate eye surgery, the surgeon will cut off the scarred tube sections left from the tubal ligation surgery. Then he will insert a suture material to be used as a stent to be sure there is no more blockage in the tube section. This is done with a special probe designed by and named for Dr. Winston, the originator of the first tubal ligation reversal procedure.

Next, he will continue to remove the damaged tube section from the part of the tube connected to the uterus and carefully threads the stent into that portion of the tube and on into the uterus making sure there is no further blockage. Once the two separate parts of the tube are lined up, our surgeon will place a couple stitches into the tissue below the tube to help hold it in place during its suturing and to take pressure off the stitches that will be placed into the layers of the fallopian tube. We don't want any pressure trying to pull those apart.

You may be wondering about all the suturing material at this point. You should know that this suture material is the same as is used in heart surgeries. It doesn't cause an inflammatory reaction nor the formation of scarring. You don't want scarring on your tubes.

Because you don't want scarring, you will find that Dr. Berger does not suture the inner layer of the fallopian tubes. This layer contains cilia which help move the egg, and later the fertilized egg, along the tube to the uterus. Any scarring here can increase your risk for an ectopic pregnancy. Instead, the tubal reversal doctor will suture the middle layer and the outer layer. As the middle layer is the muscular part, it does the major part of holding the tubes together till the healing is accomplished.

After everything is stitched up, the stent is removed from the tube at the fimbrial end. He will do the same procedure on your other tube. Once that is done, he will start the closing process stitching the various layers where it is necessary.

In fact, he will even stitch together the muscles that he had separated. This just helps reduce your chance of developing a hernia. A few stitches in the fine fascia just below the skin helps support the stitches that will hold the skin together. It just provides extra support. And just to help with the post op pain, he administers a hypogastric nerve block.

As a last step in mitigating pain, the patient will be given a TENS unit, transcutaneous electrical nerve stimulator, which stimulates the body at the point of the incision to release endorphins to help with the pain. This just goes to show the extent of what Dr. Gary Berger does both during and after a tubal reversal surgery to help you to recovery faster.