[Possibilities and limits of endoscopic fallopian tube surgery]

Treatment of distal tubal occlusion by microsurgical means allows a pregnancy rate of about 30-40% per patient. The success rate directly depends on patient's age and the grade of tubal destruction and increases to 50% in younger patients. Therefore microsurgical repair still represents a sufficient alternative to IVF. The introduction of endoscopical techniques further facilitates distal tubal surgery and offers the opportunity to evaluate the grade of tubal destruction. When performed correctly based on longstanding experience pregnancy rates after endoscopical salpingostomy are similar to microsurgery via laparotomy. In contrast microsurgery by laparotomy is still the method of choice in cases of proximal tubal occlusion or reversal of tubal ligation. Furthermore laparotomy is still indicated in patients presenting with distal tubal pathology, if the endoscopical approach does not lead to a sufficient postsurgical result.