Laparoscopic Tubal Anastomosis:Analysis of 27 Cases
- VernacularTitle:腹腔镜输卵管吻合术27例分析
- Author:
Nailiang ZHAI
;
Xia LIU
;
Jing ZHAO
- Publication Type:Journal Article
- Keywords:
Laparoscopy;
Tubal anastomosis;
Sterilization
- From:
Chinese Journal of Minimally Invasive Surgery
2005;0(11):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the feasibility and efficacy of laparoscopic tubal anastomosis after tubal sterilization.Methods A total of 27 cases of fallopian tube anastomosis with tubal anastomosis were performed under laparoscopy.After removing the sterilized scar in the tubes the hydrotubation was carried out using Methylene Blue to detect whether the tube was patent.By using 6/0 absorbable thread,we sutured the mesosalpinx with 2 or 3 stitches to close the both ends of the fallopian tube.And then,isthmus-isthmus(1 whole-layer stitch at the 12 o'clock,and then 1-stitch sutures at the serous layer of the 8 and 4 o'clock respectively)ampulla-ampulla(1 whole-layer stitch at the 12 o'clock,and then 1-stitch sutures at the whole layers of the 9,7,5,and 3 o'clock respectively),or isthmus-ampulla(same method as the ampulla-ampulla anastomosis but more closed sutures)was performed.The patients received hydrotubation at the first day after the operation and then 3 to 5 days after the first menstruation.They were followed up for every 6 months till pregnancy.Results In the 27 patients(54 tubes),the rate of patency was 88.9%(48/54).The patent rate in the patients received isthmus-isthmus or ampulla-ampulla anastomosis was 86.5%(32/37)and 100%(15/15)respectively.In the 2 cases of isthmus-ampulla anastomosis,one was patent after the operation,and in the other,the Methylene Blue test showed anastomotic leakage.The hydrotubation performed at the first day after the treatment showed a rate of patent in 25 cases(2.6%,25/27),only two patient showed obstruction of the tube(7.4%,2/27).Follow-up was available in 26 of the patients up to over 6 months,19 of them had intrauterine pregnancy(73.1%,19/26)in 24 months after the procedure,among which 89.5%(17/19)occurred in 12 months;one(3.8%,1/26)patient developed ectopic pregnancy.Conclusions Laparoscopic tubal anastomosis is safe and effective for patients who desire reversal after sterilization.
