Surgical procedure in restoration interventions for tubal obstructions

Abstract

The practical advantages of restorative surgery in tubal sterility versus in vitro fertilization (IVF) – especially the avoidance of ovarian stimulation and the risks of multiple pregnancy, the possibility of natural conception and the lower costs – have led the search for new surgical procedures. Performing the tubal isthmic incision as an initial step in solving the tubal pathological processes, both isthmic and ampullary or pavilion, aims to insert the catheter, both in the uterine cavity, facilitating its extraction at the optimum time and along the entire lumen of the restored tube, thus preventing restenosis or tubal obstruction secondary to the intervention. The use of the 0.85 mm catheter, close to the isthmic and interstitial intraluminal tubal anatomical diameter (with ɸ = 0.9 mm), avoids the destruction of the epithelial ciliated cells and non-ciliated endoluminal cells, and enables the postsurgical maintenance of physiological intraluminal diameter of the isthmic incised area. The accuracy of the surgical technique in the case of tubal repermeabilization after tubal ligation ensures a high success rate compared to IVF. In this paper, we approach a staged practical presentation of this pathology in which we highlight the advantages of the described surgical procedure.