[Tuboperitoneal infertility and operative celioscopy (endometriosis excluded)]

The great progress made in surgical celioscopy now allows most surgery for the repair of the adnexa to be performed through such an approach. The exeresis of adhesions with scissors is the safest, fastest and least traumatic technique. For salpingostomy, the eversion of the cuff is maintained by a defocused CO2 laser shot on the distal tubal serosa, or more simply, by the contact of the serosa with the bipolar pliers or with the tip of the thermocoagulation device. The results of the lysis of adhesions are satisfactory, with 53% intrauterine pregnancies in our 49-patient series. The results of distal plasty, with 27.7% intrauterine pregnancies in our 65-case series, they are quite comparable to those of microsurgical laparotomy. These results, along with the advantages of surgical celioscopy, caused us to give up microsurgical laparotomy for the treatment of operable adhesions and distal tubal lesions, even more so as in vitro fertilization must be contemplated at once for severe lesions.