Microsurgical Tubal Anastomosis Research Articles

Selective fallopian tube cannulation: initial experience in an infertile population

We have studied a group of 19 patients presenting with proximal tubal occlusion. Seventy-three percent (22/30) of tubes attempted were successfully cannulated. Sixty-two percent (5/8) of tubes remained patent in limited follow-up at 3 to 6 months. We conclude that selective fallopian tube cannulation may provide an alternative to microsurgical tubal anastomosis in selected patients.

Tubal resection and anastomosis. II. Isthmic salpingitis.

The results of 30 consecutive operations for medial occlusion of the tube due to pathological processes other than sterilization are reported. Resection of the obstructed segments was followed by anastomosis of lateral isthmus or ampulla to the medial isthmus, the interstitial portion of the tube, or the endometrium of the lateral uterine angle, deep in the myometrium. Life table analysis of subsequent pregnancies was carried out in a manner that kept those patients with demonstrated reocclusion after anastomosis in the denominator for the duration of longest follow-up, irrespective of further operations on these patients. The cumulative probability of pregnancy was 55% at 6 months from the time of surgery and 67% at 12 and at 15 months. Empirically, average fecundability, or monthly probability of pregnancy, was 9.3%; of 25 women followed-up and not on contraception, 14 (56.0%) have conceived. Microsurgical tubal anastomosis can effectively replace uterotubal implantation for acquired organic occlusion of the medial tube or lateral uterine angle. Optimum results require precise techniques, wide excision of abnormal endosalpinx, and preoperative treatment of endometritis.

Comparison of the operating microscope and loupe for microsurgical tubal anastomosis: a randomized clinical trial

Reversal of sterilization was performed by microsurgical tubal anastomosis in 72 women using either loupe (n = 36) or microscope (n = 36). The study design called for the randomization of patients within pairs, which were matched for method of sterilization and site of anastomosis. A significant difference between methods could not be demonstrated at 12 months (P = 0.39) or 24 months (P = 0.37) after the procedure.

Microsurgical tubal anastomosis: a controlled trial in four Asian centers.

An international program to determine the reversibility of female sterilization in Asia using microsurgical technique was established in 1980. One hundred eleven of 219 patients (51%) conceived following tubal anastomosis; of these, 79 delivered living children. The overall cumulative probability of conception at the end of follow-up, as determined by life-table analysis, was 63%. A decreased pregnancy rate was associated with anastomosis of tubes sterilized by electrocautery methods.

CO<SUB>2</SUB> surgical laser を用いた家兎卵管の端々吻合

Recentty, the carbon dioxide laser has been introduced into the gynecologic fields. The use of CO2 laser is very useful to avoid surgical trauma and to get complete hemostasis from the surgical margin. We have performed the end-to-end anastomosis of the rabbits fallopian tube by means of the CO2 laser (SHARPLAN 791) in order to evaluate its application in tubal microsurgery and to study the healing process and the effect on subsequent functions of the oviduct.The CO2 laser is very useful for microsurgical tubal anastomosis. Complete hemostasis can be obtained and cut end of the tube is remarkably undisturbed. To compare with 200mm and 50mm focal lenses, the former tends to cause wider tissue destruction and more epithelial changes than the latter. But, cutting of the tube using 50mm and 200mm lenses give similar pregnancy rate(50nm: 83.3%, 200mm: 91.6%).To evaluate from these resuts, the 50mm lens is preferable for tubal anastomosis to minimize thermal damage caused by CO2 laser beam and to prevent the bleeding from the cut end of the tube.

Microsurgical tubal anastomosis in the rabbit following three types op sterilisation procedure

The reversibility of Falope ring, Pomeroy and unipolar cautery methods of sterilisation was examined in 30 rabbits. Using microsurgical techniques, an overall pregnancy rate of 56.6% was attained. Reversibility was more readily achieved and resulted in a higher pregnancy rate after Falope ring than Pomeroy or cautery sterilisation. The pregnancy rate after each method of sterilisation seems to correlate with the results obtained for reversal of sterilisation in the human.