Laparoscopic tubal reconstructive surgery

Kim, Yoo Shin; Yoon, Tae ki

Abstract

Tubal and peritoneal factors account for 30% to 40% of cases of female infertility. Tubal factors include damage or obstruction of the fallopian tube. The best technique for diagnosing tubal and peritoneal disease is laparoscopy, and laparoscopic surgery has been used to various tubal conditions (such as laparoscopic fimbrioplasty, salpingectomy, salpingostomy, and tubal reversal). Approximately 1% of the women who undergo tubal sterilization subsequently request reversal of tubal sterilization. Two treatment options are available to women who wished to become pregnant after having tubal sterilization: tubal reversal or in vitro fertilization (IVF). Laparoscopic tubal reversal shows high pregnancy rates similar to laparotomy and superior to the rates reported for IVF. Hydrosalpinx is a common tubal disease that is associated with lower implantation and pregnancy rates. The proper selection of patients for surgical treatment and of the type of surgical technique are essential to achieve good results. For patients with mild tubal disease, good results can be achieved by an experienced surgeon; however, for patients with severe tubal disease, the prognosis of surgery is poor. In these cases, In-vitro fertilization (IVF) is the main line of treatment for infertility caused by hydrosalpinx.