Human Reproduction, Vol 12, 647-649, Copyright © 1997 by Oxford University Press
L Stadtmauer and MV Sauer
We tested the feasibility of performing outpatient laparoscopic surgery to
reverse tubal sterilization using titanium staples to reapproximate the
oviducts. A total of 14 women underwent the procedure which involved
excision of the tubal eschar, stenting of the severed remnants, and
circumferential stapling of the muscularis and serosa. Reapproximation was
possible in all cases, with a measured tubal length post-anastomosis 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 discharged the same day. There
were no operative complications, and no readmissions were necessary. Within
6 months of surgery there were six pregnancies including one spontaneous
abortion and five ongoing pregnancies. Of those not conceiving within 8
months, seven (100%) demonstrated tubal patency on a follow-up
hysterosalpingogram. We conclude the laparoscopic approach to tubal
sterilization reversal is a viable alternative to open abdominal
microsurgical approaches. Although preliminary, laparoscopic surgery
promises to be cost effective, as it can be performed on an outpatient
basis, may reduce operative time and minimizes the recuperative period of
patients.
ARTICLES
Reversal of tubal sterilization using laparoscopically placed titanium staples: preliminary experience
Department of Obstetrics and Gynecology, Columbia-Presbyterian Medical Center, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
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