[Per-celioscopic ampullosalpingoscopy]

If a soft malleable thin calibre fibroscope is used it is possible to look into the ampulla endoscopically while carrying out laparoscopy. The technique of the operation will be described. An analysis of the results of the investigation carried out on 96 patients (179 tubes) shows that this procedure is possible to be done harmlessly as a routine measure. This investigation has shown some particular aspects of the intra-ampullary landscape. A change in the folds of the ampulla was seen in women exposed to DES in utero. After the folds had been operated on in cases of hydrosalpinx scars persisted in the ampulla. Early diagnostic of possible ectopic pregnancies was possible. Laparoscopic ampulla salpingoscopy shows changes in the pattern of the intra-ampullary folds that could not be foreseen in about 40% of cases that had simple hysterosalpingography. This is a particularly important finding in women who have unexplained sterility. Furthermore, tubal endoscopy can often make it possible to break down and to cut pathological interfimbrial adhesions. Using this technique in 17 patients who had been sterile for more than 40 months, it was possible to achieve 11 intra-uterine pregnancies after less than 4 months interval.