[Distal tubal surgery using laparoscopy]

Between January 1987 and May 1990, forty-four women were treated in our department by laparoscopic surgery for distal tubal pathology. Among them, 10 had an intrauterine pregnancy (22.7%) and 2 had an ectopic pregnancy (4.5%) within 28 months after surgery. Subsequently, our results were expressed in terms of the type of operation performed (fimbrioplasty or neosalpingostomy) and according to the tubal and adhesion scores (Mage and Bruhat). We found that most pregnancies were obtained within the first 16 months, that fimbrioplasty gave better results than neosalpingostomy (35.7% versus 16.6%) and that the tubal score was fairly predictive and more so than the adhesion score. These results enabled us to keep as indication of distal tubal laparoscopic surgery those patients who had pure distal tubal lesions with a tubal core of 1 to 2 and normal other parameters of infertility. In case of failure, i.e. if the woman does not become pregnant within 12 months post-laparoscopic surgery, in vitro fertilization is advised.