Tubal Re-Implantation Following Hysteroscopic Tubal Sterilization

Abstract

Video Objective In this video, we demonstrate a novel laparoscopic technique of tubal re-implantation after hysteroscopic tubal sterilization with micro-inserts. Setting The patient is a thirty-eight-year-old gravida two para two who previously underwent Essure tubal occlusion. Although she understood the permanent and irreversible nature of Essure coils, she presented with desire of another pregnancy. She was well informed that in-vitro fertilization would offer her the best chance to get pregnant. However, due to personal reasons, she absolutely wanted tubal re-implantation. Interventions Laparoscopic bilateral cornuectomy, partial salpingectomy with removal of Essure coils and tubal re-implantation was performed. Postoperative management included oral antibiotics, removal of stents under hysteroscopy and hysterosalpingography. Conclusion This is the first reported case of tubal re-implantation following hysteroscopic tubal occlusion using the proposed method. The surgical steps and technical tips discussed are safe, and may help patients with desire of pregnancy following Essure insertion who seek alternative options to assisted reproductive technology.