LAPAROSCOPIC FIMBRIOPLASTY - AN EVALUATION OF 35 CASES

The aim of this prospective study was to assess the value of laparosco pic treatment of severe fimbrial occlusions. During a period of 52 mon ths infertile patients with fimbrial lesions were treated by operative laparoscopy. Only those patients requiring incision of the tubal sero sa (salpingostomy) were included, representing the most severe lesions . The most frequent cases, those patients requiring simple adhesiolysi s and deagglutination of the fringes, were excluded. All tubal lesions were documented carefully. Positive Chlamydia trachomatis (CT) serolo gy was found in 65.7% of the patients. All the patients were followed up for at least 2 years. Three patients lost to follow-up were defined as failures. The global conception rate was 74.3%. The intrauterine p regnancy rate was 51.4%, and the 'take home baby rate' was 37.1% (only the first pregnancy being taken into account). The ectopic pregnancy rate was 22.9%. A positive CT serology was found to have a significant influence on the outcome. It can be concluded that the laparoscopic a pproach provides results similar to those obtained by microsurgery for the treatment of severe fimbrial occlusions, and represents an accept able alternative to in-vitro fertilization (IVF) in selected cases.