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  • Title: Laparoscopic tubal anastomosis (the one stitch technique): preliminary results.
    Author: Dubuisson JB, Swolin K.
    Journal: Hum Reprod; 1995 Aug; 10(8):2044-6. PubMed ID: 8567838.
    Abstract:
    We report a new laparoscopic technique of tubal anastomosis: the laparoscopic one stitch technique. After preparation and approximation of the two tubal segments, the anastomosis consists of one single suture placed at the '12 o'clock' site of the antimesenteric borders. Four patients have undergone this procedure. Bilateral tubal patency was confirmed in three cases. Hysterosalpingography was not performed on the fourth patient as she was already 1 month pregnant after tubal anastomosis. During May-November 1994, in France and Sweden, gynecologists used the one stitch technique to perform laparoscopic tubal anastomosis in four women aged 32-41 who requested reversal of a previous sterilization. The two main steps of the tubal anastomosis consisted of preparing the healthy tubal segments and performing the anastomosis using microsurgical principles. The surgeons anastomosed the tubes using an i.p. suture in the mesosalpinx right adjacent to the cut stumps. They then applied the one stitch technique. One single suture was placed at the 12 o'clock site of the antimesenteric borders. It started from the serosa, passed through the muscularis, and came out of the serosa. A knot was made i.p., distal to the mucosa. The surgeons were successful in all four cases. The mean time needed for the operation was 3 hours 25 minutes. No intraoperative or postoperative complications occurred. Two to three months after the operation, three women underwent hysterosalpingography. In all three cases, the tubes were patent. The fourth patient did not undergo hysterosalpingography because she was already pregnant (4 weeks gestation). At 12 weeks amenorrhea, ultrasound confirmed a live intrauterine pregnancy. These findings encourage the gynecologists to continue their preliminary study of the effectiveness of the one stitch technique for laparoscopic tubal anastomosis.
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