Tubal Recanalization by Laparotomy
Definition
Surgical procedure performed to reverse tubal obstruction following salpingoclasia in order to restore fertility.
Indications
- Time between the Salpingoclasia and the request for Tubal Recanalization maximum of 10 years.
- Desire for pregnancy
- No chronic degenerative diseases and psychiatric illnesses.
- No previous uterine or tubal surgery.
- No previous obstetric complications.
- No more than three previous cesarean sections.
- No other factors associated with infertility.
- Length of the ends of the salpinges equal to or greater than 4 centimeters.
Prognostic factors
- Patient’s age.
- Salpingeal length after surgery.
- Type of salpingoclasia performed.
- Time between salpingoclasia and recanalization.
Tubal Recanalization by Laparotomy
- Option for couples with creed issues and has a lower cost than assisted reproduction procedures.
- Despite the material cost and risk associated with surgery, it has a better cost-benefit ratio and is recommended as a first treatment alternative.
- Open microsurgery is a procedure of choice because of its low complication rate and good results in terms of pregnancy.
- Mini laparotomy incision is recommended and is used more frequently.
It is important to…
Perform a complete pre-operative study to rule out other factors associated with infertility:
- Seminal analysis
- Ovulation study
- Evaluation of ovarian reserve
- Hysterosalpingography or hysterosonography (if available).