Outpatient Reversal of Sterilization with Laparoscopically Placed Titanium Staples
We assessed the feasibility of performing outpatient reanastomosis of the fallopian tubes using titanium staples. Twelve women underwent routine infertility evaluation followed by laparoscopic tubal anastomosis. After preparation of the fallopian tubes, cannulation was performed proximally by hysteroscope or distally with a 3F catheter stent. The mesosalpinx was approximated with titanium staples. Circumferential staples (3-4) were placed around the stented tube to approximate the tubal muscularis. Patency was documented intraoperatively by chromotubation. Mean operating time was 130 minutes (range 90-170 min). Patients were generally discharged within 6 hours of surgery. Bilateral anastomosis was performed in nine women and unilateral anastomosis in three due to inadequate tubal length. Preliminary follow-up with hysterosalpingogram at 6 months revealed 80% tubal patency, and four women are currently pregnant. We suggest that laparoscopic reversal of sterilization is a viable alternative to more traditional methods and can be performed in an outpatient setting.
Stadtmauer
L
Department of Obstetrics and Gynecology, Columbia Presbyterian Medical Center, 622 West 168th Street, PH16, New York, NY 10032.
Sauer
M