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At least 73 records · Page 4Linked to original sources
PubMed1995

Laparoscopic rescue after tubal anastomosis failure.

Laparoscopic rescue after tubal anastomosis failure is reported for the first time. The patient was a 33 year old woman sterilized by Pomeroy's method. Reconstruction of fertility was achieved by mini-laparotomy with isthmo-isthmic end-to-end anastomosis of bilateral tubes. Unfortunately, the patient did not become pregnant and tubal occlusion was diagnosed 6 months later by hysterosalpingography. Laparoscopic rescue with repeat isthmic-ampullary anastomosis and adhesiolysis was performed. Post-operatively, the patient had one menstruation and then achieved an intrauterine pregnancy. Instead of in-vitro fertilization/embryo transfer, laparoscopic rescue may be an alternative option for the patient with failed anastomosis.

Adult↗
PubMed1983

Histopathologic changes in fallopian tubes subsequent to sterilization procedures.

Longitudinal serial and serial step sections of fallopian tubes from more than 100 patients, subsequent to tubal sterilization procedures, were examined. Thirteen of these patients had pregnancies following their sterilizations. The histologic findings at the previous surgical sites were compatible with what would be expected for a normal healing process. Evidence for a unique tubal epithelial process, as suggested by the terms "endosalpingiosis" or "recanalization," was lacking. Likewise, the author found no evidence of tuboperitoneal fistula formation and/or the subsequent occurrence of pregnancy secondary to localized endometriosis. The histologic notations of proximal luminal dilatation, plical attenuation, chronic inflammatory infiltrates with pseudopolyp formation, and the findings of plical thickening in the distal segment of remaining tube after an interruption type of procedure seem to be associated with the length of time from the sterilization procedure. These may be factors related to the apparent reduced success rate, with time, of microsurgical reanastomotic procedures.

Adult↗
PubMed1983

Microsurgical repair of the fallopian tubes.

The microsurgical techniques used and the results achieved in a series of 27 patients submitted for fallopian tube repair are presented, the majority following elective sterilization.

Adult↗
PubMed1990

Macroscopic tuboplasty: reversal of female sterilization.

Data is presented regarding 57 women who underwent reversal of sterilization procedure. In the majority (90%), the reason for request for reversal of procedure was loss of male child or more than one child. Thirteen subjects never came back for follow-up. Out of 39 subjects in whom follow-up is available for more than 3 months, in 35 (90%) the tubes are patent. There were 25 pregnancies in 21 subjects and incidence of viable pregnancy was 88% with only ectopic pregnancy (4%). In these 35 cases whose tubes were found to be patent post tuboplasty, 18 had laparoscopic ring application, 16 had abdominal tubal ligation and one had undergone vaginal tubal ligation. Thirteen subjects (62%) conceived within 6 months after reversal. In this series, no loupe or operating microscope was used.

Adult↗
PubMed1989

The value of hysterosalpingography before reversal of sterilization procedures involving the fallopian tubes.

Knowledge of the length of the uterine end of the fallopian tube and the presence of tubal adhesions and fistulas is important when surgical reversal is undertaken in patients who have had tubal ligation. We retrospectively studied hysterosalpingograms in 127 such patients to determine their value in providing this information. The ligation was performed by using the Pomeroy technique in 57 patients. Sixty-one patients had bipolar electrocautery, six had Falope rings inserted, and three had Hulka clips applied. In all cases, the uterine ends of the tube were visualized to a point of obstruction. The sites of occlusion after Pomeroy ligation were midtubal (46%), cornual (16%), proximal ampullary (16%), proximal isthmic (14%), and intramural (8%). After the electrocautery procedure, the sites of occlusion were proximal isthmic (45%), intramural (20%), midtubal (19%), cornual (15%), and proximal ampullary (1%). When Falope rings and Hulka clips were used, the most frequent site of occlusion was midtubal (50%). Tubal adhesions, consistent with successful occlusion, were detected in 16 patients on the basis of a small confined area of extravasation of contrast material at the site of ligation. Tuboperitoneal fistulas, identified by the presence of contrast material spilled from the uterine end of the tube into the peritoneal cavity, were detected in five patients. Our results show that hysterosalpingography is a useful technique for determining the status of the uterine end of the fallopian tube after ligation when reversal of ligation is planned.

Female↗
PubMed1991

Postpartum tubal sterilization. A comparative study of the Hulka clip and modified Pomeroy technique.

To assess the feasibility of Hulka clip application for postpartum sterilization, 50 women were enrolled in a randomized, prospective study comparing modified Pomeroy tubal ligation and Hulka clip application. Hulka clip tubal occlusion in the postpartum period compared favorably with the commonly performed postpartum sterilization technique. Because of the simplicity of the technique and its greater potential reversibility, Hulka clip application may have advantages over standard postpartum sterilization techniques and should be considered for use in the postpartum period.

Adult↗