Tubal Ligation

Tubal Ligation Reversal Success Depends upon the Type of Tubal Ligation that was Originally Done

Tubal ligation is a commonly performed sterilization procedure. There are a variety of ways in which the procedure can be performed. Laparoscopic procedure using electro cautery, clips or rings to occlude the proximal portion of the tubes is a common method to block tubes.

Clip & Ring Tubal Ligation

Clips and rings cause a crush injury so that the blood supply in a small segment of the fallopian tube is cut off. Eventually, this segment of the fallopian tube will die.

What is left is a missing piece of the tube close to where the tube implants to the uterus (referred to as the proximal end). Once a wall segment of tube has died, the clip or ring will remain.

Tubal Ligation with Cautery

Another commonly used method is cautery. During cautery, a small segment of tube is grasped with a bipolar grasping forceps, and an electrical current is passed through it until the tube is literally fried. This usually results in approximately 2-3 cm of tubal destruction. This segment of the tube also dies and the end result is a missing segment of the tube.

Other Less Common forms of Tubal Ligation

Ligation during C-section

Sometimes a tubal ligation is performed at the same time as a cesarean section. This procedure is called a Pomeroy procedure. During this procedure, a small section of the tube is actually cut out and the ends are tied off with suture material.


A less commonly performed procedure is a fimbriectomy. During this procedure, the ends of the tube are completely removed. Because the fimbria is an essential part of the tube, this procedure is irreversible.

If a tubal reversal is to be considered, it is important to identify how the initial tubal ligation was performed. With clips or rings, there is usually enough tube left for the surgeon to work with and repair the fallopian tubes. Tubal cautery tends to cause more damage to the tube. However, in many cases these tubes are also amenable to repair.

The important thing is for the surgeon to identify that there is at least 4-5 cm of Fallopian tube to work with (average length of fallopian tube is 6-10 cm). If there is any doubt regarding whether a tubal reversal could be considered, we will first perform a laparoscopy to evaluate the quality and length of tube remaining and if there is a sufficient length of tube, he will proceed with the tubal reversal.