IMPROVED COMBINED LAPAROSCOPIC AND MINILAPAROTOMY TECHNIQUE TO ALLOW FOR REVERSAL OF EXTENSIVE TUBAL-STERILIZATION

We assessed the efficacy of combined laparoscopic and minilaparotomy f or outpatient microsurgical reversal of extensive tubal sterilization in 11 women undergoing the procedure and followed for a mean of 24.7 m onths. All patients desired reversal of extensive tubal sterilization, and had 4 cm or less of the longer oviduct remaining. The mean operat ing time was 110 minutes, and the mean total cost was $5067. There wer e no major complications. Two women were treated for uncomplicated cys titis within 1 month of surgery. Five (45%) of 11 women delivered viab le infants; one patient had two ectopic pregnancies. These preliminary data suggest that outpatient combined laparoscopy and minilaparotomy may be effective in patients who desire restoration of fertility after extensive tubal sterilization.