SALPINGECTOMY BY OPERATIVE LAPAROSCOPY AND SUBSEQUENT REPRODUCTIVE-PERFORMANCE

Between January 1984 and August 1991, 511 cases of extrauterine pregna ncies were diagnosed by laparoscopy in our department. In 374 cases sa lpingectomy was performed: 184 by explorative laparotomy, and 190 by o perative laparoscopy. Patients were scheduled for salpingectomy if one or more of the following criteria were fulfilled: (i) a ruptured tube which was surgically unsuitable for conservation; (ii) no interest in future fertility; (iii) tubes with ectopic gestation previously opera ted on; (iv) a previous tubal pregnancy on the same side, which was tr eated expectantly. Salpingectomy was performed via operative laparosco py with bipolar diathermy forceps and laparoscopic scissors. Pregnancy rates, i.e. intra-uterine and repeat extra-uterine, were evaluated. T he reproductive performance following salpingectomy did not differ sig nificantly, whether by laparotomy or laparoscopy: the intra-uterine pr egnancy rate was 78 and 64%, respectively and the repeat ectopic pregn ancy rate was 12 and 6%, respectively. Salpingectomy via laparoscopy c an be performed safely with a low incidence of complications, with sub sequent reproductive performance comparable to laparotomy.