Tubal Reversal Procedure Comfort
Posted by Mike Malone | Posted in Uncategorized | Posted on 06-07-2010-05-2008
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Making Tubal Reversal Comfortable
by Gary S. Berger, MD
Reproductive Surgeon-Director
Chapel Hill Tubal Reversal Center
Using The Best Surgical And Anesthetic Techniques
Tradionally, tubal reversal surgery microsurgery has been a major in-hospital operation with several days of hospital stay and surgical techniques that cause postoperative pain and disability. They don’t think about how to minimize postoperative pain while performing a surgical procedure. Patients, of course, would prefer that surgeons avoid techniques that cause pain after they awake.
Postoperative pain following abdominal surgery is due mostly to trauma to the muscles and connective tissues in the abdominal wall when using traditional surgical techniques. Abdominal retractors (metal instruments that pull back on the skin, connective tissues, and muscles to provide exposure of the pelvic organs), cause bruising and reduced blood flow to tissues during the time they are being held apart by the retractors. In my experience – having performed over 6000 outpatient tubal reversals – the operation is best performed using no retractors at all other than just the surgeon’s fingers, the gentlest of all surgical instruments.
Surgical packs (large gauze pads) traditionally are placed into the abdomen to push the intestines away from the pelvic organs. These irritate the intestines and are unnecessary in most cases.
Another technique that prevents postoperative pain is injecting a local anesthetic, even though the patient is asleep, in the areas where surgery is performed . This effective technique is called “pre-emptive analgesia”.
These are some of the methods that I use that make tubal reversal comfortable as outpatient surgery. These techniques allow patients to awake in comfort and avoid the need for repeated injections of narcotic pain medications. Making surgery comfortable improves patient outcomes, avoids the need for routine postoperative hospital care, and results in low cost tubal reversal.
