L. Stadtmauer et Mv. Sauer, REVERSAL OF TUBAL-STERILIZATION USING LAPAROSCOPICALLY PLACED TITANIUM STAPLES - PRELIMINARY EXPERIENCE, Human reproduction, 12(4), 1997, pp. 647-649
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.