Tuboplasty refers to a number of surgical operations that attempt to restore patency and functioning of the
fallopian tube(s) so that a pregnancy could be achieved. As tubal infertility is a common cause of
infertility, tuboplasties were commonly performed prior to the development of effective
in vitro fertilization
In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating an individual's ovulatory process, removing an ovum or ova (egg or eggs) f ...
(IVF) or repair of any type of tube-like structure, including the
Eustachian tube in the head and neck.
Types
Different types of tuboplasty can be distinguished:
* Tubal reanastomosis, involves resection of occluded tubal tissue and joining the healthy segments.
* Fimbrioplasty, separating agglutinated fimbriae.
* Salpingostomy, creating a new distal opening for the tube.
* Salpingolysis, removing adhesions from around the tube.
* Cornual implantation, resecting of an occluded transmural segment of the tube and connecting the distal patent segment of the tube to the
uterus
The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The ...
so that it links up with the endometrial cavity.
Techniques
Above surgical procedures are performed through either a
laparotomy
A laparotomy is a surgical procedure involving a surgical incision through the abdominal wall to gain access into the abdominal cavity. It is also known as a celiotomy.
Origins and history
The first successful laparotomy was performed without ane ...
or
laparoscopy
Laparoscopy () is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.Medlin ...
approach.
Techniques include the use of
microsurgery
Microsurgery is a general term for surgery requiring an operating microscope. The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerves (typically 1 mm in diameter) whic ...
,
laser
A laser is a device that emits light through a process of optical amplification based on the stimulated emission of electromagnetic radiation. The word "laser" is an acronym for "light amplification by stimulated emission of radiation". The fi ...
,
electrocautery
Cauterization (or cauterisation, or cautery) is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, o ...
,
hydrodissection Hydrodissection is the process of injecting small amounts of a special fluid into the capsule of the lens in the eye in order to make dissection easier. It makes the surgeon more capable of performing maneuvers during extracapsular or phacoemulsifi ...
, mechanical
dissection, and use of surgical
stents
In medicine, a stent is a metal or plastic tube inserted into the lumen of an anatomic vessel or duct to keep the passageway open, and stenting is the placement of a stent. A wide variety of stents are used for different purposes, from expanda ...
, hoods, adhesions barriers, and more.
Results depend on the underlying pathology and the skill of the surgeon.
Pregnancy rate Pregnancy rate is the success rate for getting pregnancy, pregnant. It is the percentage of all attempts that leads to pregnancy, with attempts generally referring to menstrual cycles where insemination or any artificial equivalent is used, which ma ...
s may range from 0–48% (Rock, 1985).
is a complication after a tuboplasty. It may require a
salpingectomy
Salpingectomy refers to the surgical removal of a Fallopian tube. This may be done to treat an ectopic pregnancy or cancer, to prevent cancer, or as a form of contraception.
This procedure is now sometimes preferred over its ovarian tube-sparin ...
(removal of a tube).
History
Schroder is credited to have performed the first tuboplasty when he created an ampullary cuff and thus reopened an occluded tube in 1884.
[ The first postoperative pregnancy was reported by Martin in 1891, however it aborted. For about a century tuboplastic procedures were the main approach to correct tubal infertility situations. With the development of IVF technology, IVF has increasingly supplanted tuboplasty as a treatment for tubal infertility.{{cn, date=February 2022
]
See also
* Fallopian tube obstruction
Fallopian tube obstruction, also known as fallopian tube occlusion is a major cause of female infertility. Blocked fallopian tubes are unable to let the ovum and the sperm converge, thus making fertilization impossible. Fallopian tubes are also ...
References
Gynecological surgery