REVERSAL OF TUBAL-STERILIZATION USING LAPAROSCOPICALLY PLACED TITANIUM STAPLES - PRELIMINARY EXPERIENCE

We tested the feasibility of performing outpatient laparoscopic surger y to reverse tubal sterilization using titanium staples to reapproxima te the oviducts, A total of 14 women underwent the procedure which inv olved excision of the tubal eschar, stenting of the severed remnants, and circumferential stapling of the muscularis and serosa, Reapproxima tion was possible in all cases, with a measured tubal length post-anas tomosis of 4.5 +/- 0.5 cm (range 3.0-7.0 cm), The length of operating time was 2.8 +/- 0.2 h (range 2.2-3.8 h), and all patients were discha rged the same day, There were no operative complications, and no readm issions were necessary, Within 6 months of surgery there were six preg nancies including one spontaneous abortion and five ongoing pregnancie s, Of those not conceiving within 8 months, seven (100%) demonstrated tubal patency on a follow-up hysterosalpingogram, We conclude the lapa roscopic approach to tubal sterilization reversal is a viable alternat ive to open abdominal microsurgical approaches, Although preliminary, laparoscopic surgery promises to be cost effective, as it can be perfo rmed on an outpatient basis, may reduce operative time and minimizes t he recuperative period of patients.