Tubal Reversal Surgery
Dr. Jeffrey Keenan is one of the most experienced surgeons in the Southeast when it comes to performing tubal reversal surgery. New patients are seen at our office in Knoxville and he performs the reversal surgery at Tennova Turkey Creek Medical Center, conveniently located just 10 minutes from our office. Turkey Creek Medical Center has the advanced equipment and staffing needed to ensure the highest success rates possible! Our success rates are second to none! Call soon for your appointment.
FAQs & Information
What is Tubal Reversal?
Women who have previously undergone a tubal ligation and now wish to conceive can either pursue in vitro fertilization (IVF) or tubal reversal surgery (also called reanastomosis). Tubal reversal is a safe, effective operation which has been performed successfully for decades. Dr. Keenan has almost 30 years of experience in performing this procedure using the operative microscope.
When you are considering having a tubal reversal procedure it is essential that you pick an experienced physician, who is trained in the use of microsurgical instruments and techniques, to perform this delicate operation. We believe the best way to perform this surgery is with the use of an operative microscope and the use of sutures that are extremely fine and commonly used in eye surgery. The openings of the tubes which must be reconnected are typically very small. Failure to properly align the segments, even by as little as one millimeter, can make the difference between a successful and an unsuccessful operation.
Dr. Keenan has been performing this operation with outstanding success since 1990. He is one of the most highly recognized experts in the entire Southeastern United States in performing tubal reversals. Patients come from across the U.S. to take advantage of his expertise and have their procedure performed at a reasonable price.
Watch our YouTube video by clicking here.
About the Operation
Dr. Keenan typically performs this procedure on an outpatient basis, using a small 6 cm bikini-type incision. He does not perform the procedure laparoscopically, although this could be considered under special circumstances. The operation typically takes 2 ½ to 3 hours. Long-acting local anesthetic (numbing medicine) is injected into each tissue layer at the close of the operation so that the patient is comfortable enough to leave the surgery center following the operation. Recovery time is shorter because of the small incision size, but your ability to return to normal activities or work will vary.
Tubal Reversal Images
Some patients love looking at medical/surgical images while others are not so inclined! For those who are curious as to what the actual surgery looks like, Dr. Keenan has provided a step-by-step guide to performing a bilateral tubal reversal. Click HERE to see actual photos of the steps in a tubal reversal procedure.
Tubal Reversal and Overweight Women
Unlike many clinics, we do offer tubal reversal to overweight women. However, the extra time and effort requires an additional charge. Please see Financial Considerations below for more information.
We do not operate on patients over 300 pounds or with a BMI (Body Mass Index) over 38. Patients that are significantly overweight (but with BMI < 38) may not be able to have their operation performed on an outpatient basis. This is because the abdominal wall may be too thick to utilize the very small incision, so a larger incision must be made, which may require an overnight hospital stay. This determination will be made at the time of the initial exam. Exceptions to the requirement for post-operative hospitalization can be considered if around-the-clock nursing care is available to the patient for 24 hours. Unfortunately, there is no way to determine the likelihood of being able to perform the operation through a small incision as an outpatient without performing a physical exam. You should also be aware that, in rare cases, too much of the tube may have been removed to successfully perform this operation. Also, severe scar tissue or other abnormalities could prevent the successful performance of this operation. Of course, these situations will not be known until the time of the operation.
Factors Which Influence Success Rates
The success rate of the operation, defined as the ability to conceive intrauterine pregnancy, approaches 80%.
The type of tubal ligation can influence the success rate of the procedure. However, most types of sterilizations can be reversed. This includes burning, cutting, tying, banding, and clipping. The amount of tube which has been removed or destroyed may also influence the success rates, since at least 4 cm of tube are needed to achieve optimal pregnancy rates. However, we have seen pregnancies in women with tubes as short as 2 cm. Time since the tubal ligation was performed may play a minor role, but we have seen successful pregnancies even in patients who have had their tubes tied for 15 to 20 years. The age of the patient is also significant. We have had successful pregnancies in women well over the age of 40, but fertility generally decreases at age 40, and expectation for pregnancy must be appropriately adjusted. Finally, any concurrent infertility factors, such as absent or infrequent ovulation or low sperm counts, could lower the chance of a successful pregnancy after this operation.
Tubal reversal is one of the safest gynecologic operations. We have never had a serious post-operative complication following this surgery. There is a risk of tubal (ectopic) pregnancy following this or any tubal operation. Therefore, it is necessary to perform a very early evaluation to rule out tubal pregnancy in a woman who has undergone reversal of sterilization. Other risks will be discussed at the time of your visit.
It is helpful to have a copy of the operative note from the tubal ligation operation as well as a pathology report on the tubal segments which were removed, if applicable. To rule out significant problems with the sperm, a semen analysis on the husband is also recommended. Dr. Keenan may recommend that a hysterosalpingogram (HSG), an X-ray of the uterus and attached tubal segments, be performed prior to your surgery. Those traveling from outside the area can have these tests ordered by their local physician and bring the results with them at the time of their initial visit.
Surgery for reversal of sterilization is covered by some, but not most, insurance policies.
Outpatient fees for this operation are $3,700 for the hospital fee, $700 for anesthesia, and $2,600 for surgeon's fees (A total of $7,000). If inpatient hospitalization is necessary, the total charges will be higher and dependent upon the length of stay in the hospital (usually $750 for one overnight).
A non-refundable $500 deposit must be paid in advance.
The remainder is due the day prior to surgery (money order, cashier's check, Visa, Mastercard or Discover). Anesthesia and Tennova Turkey Creek Surgery Center fees may also be required in advance.
Patients who are more than 50% over their ideal body weight must pay an additional fee of $900. We do not operate on patients over 300 pounds or with a BMI (Body Mass Index) over 38.
Additional fees may apply if the patient’s surgical history or exam indicate that a significantly longer operating time is anticipated.
$ 500 Non-refundable fee for scheduling and preoperative history and exam.
$ 2,600 Surgeon’s fee
$ 3,700 Surgery center fee
$ 700 Anesthesia fee
$ 7,500 Total cost for BMI < 32
$ 900 High BMI fee
$ 750 Overnight hospital stay
$ 9,150 Total cost for high BMI (> 32 and < 38)
To arrange payment for Turkey Creek Medical Center, please call their
Pre-registration Department at (865) 218-5525 and let them know you are paying for bilateral tubal reversal at the contracted rate above. The procedure code is 58752.
To arrange payment for anesthesia, please contact Cassandra at American Anesthesiology at (865) 342-8990 extension 190 or Carolyn at extension 240.
Our office accepts VISA, Mastercard, and Discover, with a 2% surcharge, or cashier’s checks.
*Fees are subject to change without notice.
Is Tubal Reversal the Only Option?
No. In vitro Fertilization (IVF) is usually an option as well. However, tubal reversal generally carries a somewhat higher pregnancy rate at a slightly lower cost, and therefore is a better option for many couples. Couples with a history of very low sperm counts, significant pelvic scarring or infection, or other problems may be better served by IVF . Please click here to see the corresponding web page about our IVF Program, or call our office for additional information at 865-777-0088.
Information for Out of Town Patients
Patients traveling from outside the East Tennessee region may want to fly into Knoxville's McGhee-Tyson Airport. The Tri-Cities and Chattanooga airports are each approximately a 90-minute drive. Nashville International Airport is a two and one half hour drive. We require you to be seen in the office the day prior to surgery, and you must stay in town the night following the operation. Some local hotels are located approximately 10 minutes from Southeastern Fertility. We have a special rate arranged for our patients at two local hotels.
Staybridge Suites Knoxville West
11319 Campbell Lakes Drive
Knoxville, TN 37934
Special Rate: $99/night (plus tax)
Hampton Inn & Suites Turkey Creek/Farragut
11340 Campbell Lakes Drive
Knoxville, TN 37934
Phone: (865) 966-0303
Fax: (865) 966-0305
Special Rate: $99/night (plus tax)
Under "Special Accounts & Rates" enter the code 0002778140 under "Promotion/Offer Code" and the discounted rate will be applied. The rate is subject to availability, and rates are subject to change without notice.
A physician referral is not required for an appointment. Our policy is to treat only married couples. Further information may be obtained by calling our office or click here to contact us via the website contact form.