Laparoscopic tuboplasty with or without robotic assistance

Abstract

Tubal disease represents one of the most important causes of infertility. Although most cases are secondary to sexually transmitted disease, tubal anastomosis represents a significant number of cases. Worldwide, more than 190 million couples have chosen sterilization as their contraceptive method. As many as 20% will express regret due to a change in family circumstances such as the death of a child, an improved economic situation, or a change in marital status; 1-5% of these patients will request sterilization reversal. Tubal disease amenable to surgical intervention can be divided into three approaches:● cornual – which is treated radiologically or hysteroscopically and will not be covered in this chapter● midportion – which is typically due to a previous tubal ligationFor couples desiring fertility after tubal ligation, only two options are available: surgical tubal reanastomosis and in vitro fertilization. Tubal reanastomosis can be performed through a laparotomy incision, laparoscopically, or with robotic assistance. Integrated computer robotic systems allow for three-dimensional vision, tremor filtration, and intraabdominal articulation, affording the same advantages as laparo-tomy to the surgeon. Initial feasibility studies have been optimistic.