title: Pelviscopic reversal of tubal sterilization with the one- to two-stitch technique.
abstract: OBJECTIVE
  To describe 28 pelviscopic proximal reversals of tubal sterilization.
  
  
  METHODS
  Cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  Twenty-eight women.
  
  
  METHODS
  Twenty-two women underwent bilateral and six unilateral tubal end-to-end anastomosis through a catheter introduced through the working channel of a hysteroscope for a combined hysteroscopic-laparoscopic operation.
  
  
  RESULTS
  In the two-stitch technique the first stitch adapted the mesosalpinx and the second (4-0 or 6-0 material) to unite the tube muscularis. In some cases a third stitch was applied to either the muscularis or mesosalpinx. In all cases the wound was sealed with tissue col at the end of the procedure. Tubal patency was achieved in 95% of bilateral anastomoses and 100% of unilateral ones. Seventeen pregnancies (61%) were achieved within a minimum of 6 months and a maximum of 4 years. Fifteen patients (54%) had an intrauterine pregnancy with normal delivery and two (7%) had a tubal pregnancy. No abortions occurred.
  
  
  CONCLUSIONS
  Laparoscopic end-to-end anastomosis is a suitable surgical alternative to tubal end-to-end anastomosis by laparotomy and has all the advantages of a laparoscopic procedure.
authors.affiliation: Department of Obstetrics and Gynecology, University of Kiel, Michaelisstrasse 16, 24105 Kiel, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Mettler
authors.forename: M
authors.initials: M
authors.lastname: Ibrahim
authors.forename: E
authors.initials: E
authors.lastname: Lehmann-Willenbrock
authors.forename: A
authors.initials: A
authors.lastname: Schmutzler
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D015331:Cohort Studies; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D010535:Laparoscopy; D011247:Pregnancy; D011271:Pregnancy, Ectopic; D013243:Sterilization Reversal / Q000379:methods*; D013246:Sterilization, Tubal; D013536:Suture Techniques