Tubal sterilization is currently the commonest method of birth control (500,000 per year in the USA). A wide variety of reasons make 3 to 5% of women who had previously undergone tubal sterilization requesting subsequent reversal of the procedure to restore their fertility.
Microsurgical reversal of tubal sterilization is reliable and we already obtained encouraging results. Laparotomy is the most frequently used microsurgical technique for this reversal, with results showing intrauterine pregnancies ranging from 50 to 80% and a rate of ectopic pregnancy less than 5% in these series. Significant progress in laparoscopic surgery has made it possible today to reverse tubal sterilization by laparoscopy. Since the first reversal performed using biological glue, several laparoscopic techniques have been developed and result in satisfactory outcome. The aim of the present study was to evaluate fertility outcome after laparoscopic microsurgical tubal anastomosis (one-stitch technique). We carried out a retrospective study of 51 patients seeking reversal of previous tubal sterilization. The mean age of the patients was 33.2 years (range: 30-44.5 years). Surgery lasted 122 minutes on average, (60-204 minutes). Mean time to pregnancy was 8.2 months (4-32 months) and the rate of pregnancy obtained was 56.2%. Twenty seven patients became pregnant and 12 had ectopic pregnancies; of the 15 intrauterine pregnancies, 3 miscarried spontaneously before 9 weeks. Our study observed valuable qualities of feasibility, simplicity and rapidity of the âone-stitch techniqueâ in laparoscopic tubal anastomosis surgery, with related good rates of intrauterine pregnancy. The rate of pregnancy obtained is fairly similar to the rates reported in the literature with the same technique. However, the high proportion of ectopic pregnancies makes us believing that laparoscopic procedures using more than one single stitch should be preferred. Laparoscopic Tubal Anastomosis. An Assessment of the âOne-Stitch Techniqueâ: Jean-Marc Ayoubi, Jean Bouquet de la Joliniere, Anis Feki and Jean-Claude Pons.
Last date updated on June, 2014