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  • Title: Laparoscopic tubal anastomosis and reversal of sterilization.
    Author: Barjot PJ, Marie G, Von Theobald P.
    Journal: Hum Reprod; 1999 May; 14(5):1222-5. PubMed ID: 10325266.
    Abstract:
    Fallopian tube interruption is a common form of contraception worldwide. For a variety of reasons (e.g. change in marital status, wish for additional children, psychological factors), many of these women seek restoration of fertility. Laparoscopic tubal anastomosis is one of the newest of these procedures by which this can be achieved. Sixteen women underwent laparoscopic microsurgical anastomosis. We used a three-stitches technique with tubal cannulation adapted from methods described in the literature. Five pregnancies occurred, giving an overall pregnancy rate of 31.2%. Surgical outcome depends on the patient's age, the method of tube interruption and the length of Fallopian tube segments being anastomosed. In this study, the feasibility of laparoscopic tubal sterilization reversal is confirmed, as well as the benefits offered by laparoscopic procedures in terms of quality of life. Further improvement of surgical outcome will be achieved not only through better laparoscopic techniques but also through careful screening for surgical indications. This study examined the reliability of laparoscopic tubal anastomosis, a commonly used birth control method. The study was conducted between January 1996 and December 1997 in 16 patients who underwent laparoscopic microsurgical tubal anastomosis. A technique requiring 3 stitches with tubal cannulation was used. Within a period of 6 months, there were 5 reported pregnancies, 1 ectopic and 4 ongoing. These showed a 31.2% overall pregnancy success rates. Mean age in the occurrence of pregnancies was 33.4 years. An association of infertility factors was found in 5 patients. Infertility factors included sperm abnormalities, tubal endometriosis, and salpingitis. From these findings, it was concluded that the surgical outcome depended on the patient's age, method of tube interruption and length of Fallopian tube segments to be anastomosed. Moreover, the study confirms the feasibility of laparoscopic tubal sterilization, as well as its offered benefits.
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