title: Improved combined laparoscopic and minilaparotomy technique to allow for reversal of extensive tubal sterilization.
abstract: We assessed the efficacy of combined laparoscopic and minilaparotomy for outpatient microsurgical reversal of extensive tubal sterilization in 11 women undergoing the procedure and followed for a mean of 24.7 months. All patients desired reversal of extensive tubal sterilization, and had 4 cm or less of the longer oviduct remaining. The mean operating time was 110 minutes, and the mean total cost was $5067. There were no major complications. Two women were treated for uncomplicated cystitis within 1 month of surgery. Five (45%) of 11 women delivered viable infants; one patient had two ectopic pregnancies. These preliminary data suggest that outpatient combined laparoscopy and minilaparotomy may be effective in patients who desire restoration of fertility after extensive tubal sterilization.
authors.affiliation: Department of Obstetrics and Gynecology, Gundersen/Lutheran Medical Center, La Crosse, Wisconsin, USA.
authors.forename: P D
authors.initials: PD
authors.lastname: Silva
authors.forename: H E
authors.initials: HE
authors.lastname: Perkins
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000191:economics; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000191:economics / Q000379:methods; D001835:Body Weight; D003365:Costs and Cost Analysis; D003556:Cystitis / Q000209:etiology; D004564:Electrocoagulation; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D007813:Laparotomy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D008866:Microsurgery / Q000009:adverse effects / Q000191:economics / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D011271:Pregnancy, Ectopic / Q000209:etiology; D011446:Prospective Studies; D013243:Sterilization Reversal / Q000009:adverse effects / Q000191:economics / Q000379:methods; D013246:Sterilization, Tubal; D013997:Time Factors