Outpatient Tubal Reanastomosis Performed by Combined Laparoscopy and Minilaparotomy

From January 1992 to July 1993, 30 women underwent minilaparotomy for tubal reanastomosis in a surgery center. Laparoscopy was done and if favorable, minilaparotomy with exteriorization of the uterus and microsurgical tubal reanastomosis was performed. Cost was determined from the surgery center and surgeon's bill and compared with hospital costs of inpatient tubal reanastomosis in nearby hospitals. Mean operating time was 1.7 hours, and mean blood loss was 20 ml. Twenty-seven (90%) were discharged the same day, two (6.6%) were 23 hour stay, and one required hospitalization for two nights. There were no immediate or postoperative complications. Early crude pregnancy rate was 50% with 10% ectopic rate. Tubal patency was confirmed in 29 (96%) patients. The average total cost to the patient was $5,200.00. Tubal reanastomosis can be effectively performed as an outpatient, reducing costs, giving comparable pregnancy rates, and accelerating patient recovery.