Korean J Obstet Gynecol.  2001 Mar;44(3):566-572.

Comparison of tubal patency and pregnancy rate in microsurgical reanastomosis of rabbit fallopian tube using contact Nd-YAG Laser and suture materials

• Kim JH
• Yoo SW
• Cho HH
• Kim HY
• Kim MR
• Kwan DJ
• Lim YT
• Kim JH
• Lee JW

Abstract

OBJECTIVE
Many different methods have been undertaken to increase the success rate of tuboplasty. Ttubal reanastomosis, Nd-YAG laser, splint he development of a new generation of surgical lasers has offered a possibility for the practical use of the laser technique in microsurgical fields. In gynecology, the laser beam has been reported to be a precise instrument for successful tubal surgery with minimal bleeding and postoperative reaction. The authors studied the effect of the infrared laser beam in the area of tubal reanastomosis.
METHODS
To compare tubal patency, pregnancy rate, and histologic difference in site of anastomosis, total 120 tubes of 60 rabbits were used for experimental tuboplasty. The study groups were divided according to the kinds of reanastomosis methods. Group I : 1 layer(right tube) and 2 layer(left tube) anastomosis without using splint, group II : 1 layer(right tube) and 2 layer(left tube) anastomosis with using splint, group III : reanastomosis using laser with splint(III-b) and without splint(III-a).
RESULTS
1. The infiltration of inflammatory cell were observed in all group by optical microscopic examination. Group II revealed more fibrotic change and inflammatory cell without significant statistical difference and there was no significant difference between left and right tubes in each group. 2. The tubes of group II were significantly more patent(75%) than that of group I(50%). Especially the patency of group III performed Nd-YAG laser with splint was the highest(90%). 3. The pregnancy rates in groups without splint were 40%(one layer without splint, group I-right tube), 60%(two layer without splint, group I-left tube), 30%(Nd-YAG laser without splint, group III-a), were significantly lower than that of group with splint, 60%(one layer with splint, Group II-right tube), 60%(two layer with splint, Group II-left tube), 80%(Nd-YAG laser with splint, Group III-b). Especially the group IIIb showed the hightest pregnancy rate(80%).
CONCLUSIONS
From the above results, it is considered that the tubal reanastomosis using splint and Nd-YAG laser will improve the pregnancy rate and could be the procedure of choice in the future.

Keyword

tubal reanastomosis; Nd-YAG laser; splint

MeSH Terms

Fallopian Tubes*
Female
Gynecology
Hemorrhage
Lasers, Solid-State*
Pregnancy Rate*
Pregnancy*
Rabbits
Splints
Sterilization Reversal
Sutures*