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Outpatient laparoscopic tubal anastomosis and subsequent fertility
F Bissonnette1, L Lapensée, R Bouzayen
1Department of Obstetrics and Gynecology, Centre Hospitalier de l'Université de Montréal, Québec, Canada. fbis@videotron.ca
Objective:
To determine the reproductive outcome of women who undergo laparoscopic tubal anastomosis.
Design:
Observational prospective study.
Setting:
University-affiliated infertility medical center.
Patient(S):
One hundred two patients seeking reversal of tubal sterilization.
Intervention(S):
Laparoscopic tubal anastomosis was performed with a one-suture technique.
Main Outcome Measure(S):
Pregnancy rate.
Result(S):
There were 69 isthmic-isthmic, 16 isthmic-ampullary, 12 cornual-isthmic, and 5 ampullary-ampullary anastomoses. The mean operative time was 71.35 minutes. Eight patients had bilateral tubal obstruction on postoperative hysterosalpingography. Sixty-nine patients (70%) conceived. Sixty-four (65.3%) had ongoing intrauterine pregnancies, 15 (21.7%) had spontaneous abortions, and 5 (7.2%) had ectopic pregnancies.
Conclusion(S):
This study demonstrates that laparoscopic tubal anastomosis can be done safely and successfully on an outpatient basis, reducing costs and postoperative morbidity while accelerating the patient's return to normal activities.