LAPAROSCOPICALLY ASSISTED EXTRACORPOREAL NEOSALPINGOSTOMY - A CASE-REPORT

BACKGROUND: Laparoscopic neosalpingostomies can be time consuming, cos tly and technically difficult, resulting in suboptimal results in inex perienced hands. Extracorporeal techniques for pelvic and abdominal or gans have already been previously reported in the literature, involvin g such organs as the appendix, ovary and small bowel. CASE: A 33-year- old white woman, gravida 0, diagnosed with a history of primary infert ility, underwent diagnostic laparoscopy/hysteroscopy. Stage IV endomet riosis was diagnosed and was accompanied with bilateral tubal occlusio n with complete obliteration of the fimbriae bilaterally Extracorporea lization of the fallopian tubes was performed,followed by microsurgica l neosalpingostomies. Operative time for both neosalpingostomies was 2 0 minutes. CONCLUSION: When controlled for tubal mucosa integrity, pre vious data from one researcher comparing microsurgical laparotomy and laparoscopic neosalpingostomies shows a higher fertility rate with ope n surgical techniques. This may be explained, in part, by suboptimal r epair of the distal tubes by a laparoscopic technique. This extracorpo real technique may aid in shorter surgery and anesthesia times, higher intrauterine pregnancy rates and higher successful surgical completio ns. Prospective evaluation of multiple patients will be necessary to a ssess its efficacy. Even if pregnancy rates do not differ, operative t ime and cost may be significantly reduced.