Bilateral Tubal Ligation Research Articles

Successful End-to-End Tuboplasty Following Previous Ligation: Report of a Case

When a woman desired to become pregnant after previous bilateral tubal ligation an end-to-end tuboplasty was performed in February 1967. The couple was first advised of the low probability of successful surgical correction the considerable risk of ectopic pregnancy and the necessity of delivery by cesarean section. When laparotomy was performed the proximal and distal portions of each fallopian tube were found to be separated by a distance of about 1 in as expected after Pomeroy ligation. Bilaterally the stump of the distal portion of one fallopian tube was excised. A 19-gauge polyethylene tube 12-in long was inserted into the lumen and threaded carefully out of the fimbriated end of the fallopian tube. After the stump of the proximal portion of the remaining fallopian tube was excised the other end of the polyethylene tube was carefully threaded. The ends of the polyethylene tubes were tied together securely with No. 1 nylon thread. Anastomosis of the fallopian tubes followed using 4 sutures of 5-0 Dacron on an atraumatic needle passing the serosal muscularis and submucosal layers only. On the eighth postoperative day tubal peristalsis and/or uterine contractions ejected the entire nylon and polyethylene complex entirely into the vaginal fornix making removal unnecessary. In December 1967 and again 1 year later the patient was delivered of a child.