[Racket-shaped tubal-uterine anastomosis. Technic and results]

Proximal tubal lesions that are discovered when a case of sterility is being worked out are polymorphic in nature and they are variable in extent. Fortunately it is rare that a proximal tubal lesion should involve the whole interstitial portion and the uterine os of the tube. This is why many surgeons have taken up the method of tubo-uterine implantation advocated by Palmer. Salat-Baroux and Cornier published a paper on microsurgical tubo-interine implantation in 1979. We since 1978 have been carrying out a technique of tubo-uterine anastomosis in raquette shape (mostly isthmo-uterine). This is described in detail in this article. The first results on 32 anastomose carried out in 23 patients who were operated on of whom 17 cases had pure cornual lesions and 6 cases bipolar lesions seem to be encouraging with a patency rate 6 months later of 69% and a rate of intra-uterine pregnancy of 23.2% (0.10-0.41) at 12-18 months and 31.1% (0.14-0.56) at 18-24 months (using an actuarial method). Up to now we have not had an extra-uterine pregnancy near the site of suture. Our technique seems to us to give a worthwhile alternative microsurgical method to implantation in interstitial lesions that are widespread and deep.