Loupes or microscope for tubal anastomosis? An experimental study

Standardized tubal anastomoses were performed alternatively using magnifying loupes or an operating microscope in 44 rabbits. The surgeon's personal assessment of the integrity of the anastomoses was subsequently compared with the histologic result and with pregnancies and nidation indices. After an initial learning period, the surgeon became equally satisfied with his intraoperative assessment of the anastomoses in both treatment groups. Healing was marginally better when the microscope was employed. Animals which had tubal anastomosis performed with the use of the microscope became pregnant in 81% of cases, whereas when the loupes were employed only 5% became pregnant. Measurement of the nidation index showed similar trends. It is concluded that the use of the microscope will offer superior results once the surgeon has gained limited experience with its use.