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 Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unwanted pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth contr ...

. This procedure is now sometimes preferred over its ovarian tube-sparing counterparts due to the risk of

ectopic pregnancies Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms ...

. For contraceptive purposes, this procedure is irreversible and more effective than tubal ligation.

Classification

Salpingectomy is different from and predates both salpingostomy and salpingotomy. The latter two terms are often used interchangeably and refer to creating an opening into the tube (e.g. to remove an ectopic pregnancy), but the tube itself is not removed. Technically, the creation of a new tubal opening (''os'', after the Latin word for ''mouth'') by surgery would be a ''salpingostomy'', while the incision into the tube to remove an ectopic is a ''salpingotomy''.

Indications

The procedure was performed by

Lawson Tait Lawson Tait, born Robert Lawson Tait (1 May 1845 – 13 June 1899) was a pioneer in pelvic and abdominal surgery and developed new techniques and procedures. He emphasized asepsis and introduced and advocated for surgical techniques that significa ...

in 1883 in women with a bleeding ectopic pregnancy; this procedure has since saved the lives of countless women. Other indications for a salpingectomy include infected tubes (as in a

hydrosalpinx A hydrosalpinx is a condition that occurs when a Fallopian tube is blocked and fills with serous or clear fluid near the ovary (distal to the uterus). The blocked tube may become substantially distended giving the tube a characteristic sausage-li ...

) or as part of the surgical procedure for tubal cancer. A bilateral salpingectomy will lead to sterility, and was used for that purpose; however, less invasive, possibly reversible procedures have become available as tubal occlusion procedures. Bilateral salpingectomies continue to be requested by some voluntarily childfree people over tubal ligation because it reduces the risk of developing cancer; this is called

prophylactic salpingectomy Prophylactic salpingectomy is a preventative surgical technique performed on patients who are at higher risk of having ovarian cancer, such as individuals who may have pathogenic variants of the BRCA1 or BRCA2 gene. Originally salpingectomy was u ...

. It can be performed non-electively on women who are at a high risk of developing ovarian cancer, as a preventative measure.

Process

Salpingectomy has traditionally been done via 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 ...

; more recently however,

laparoscopic 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 ...

salpingectomies have become more common as part of

minimally invasive surgery Minimally invasive procedures (also known as minimally invasive surgeries) encompass surgical techniques that limit the size of incisions needed, thereby reducing wound healing time, associated pain, and risk of infection. Surgery by definition ...

. The tube is severed at the point where it enters 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 ...

and along its mesenteric edge with hemostatic control.

Salpingo-oophorectomy

Salpingectomy is commonly done as part of a procedure called a salpingo-

oophorectomy Oophorectomy (; from Greek , , 'egg-bearing' and , , 'a cutting out of'), historically also called ''ovariotomy'' is the surgical removal of an ovary or ovaries. The surgery is also called ovariectomy, but this term is mostly used in reference ...

, where one or both

ovaries The ovary is an organ in the female reproductive system that produces an ovum. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. There is an ovary () found on each side of the body. T ...

, as well as one or both Fallopian tubes, are removed in one operation (a ''Bilateral'' Salpingo-Oophorectomy (BSO) if both ovaries and Fallopian tubes are removed). If a BSO is combined with an abdominal hysterectomy (there are different methods of hysterectomy available), the procedure is commonly called a TAH-BSO: Total Abdominal Hysterectomy with a Bilateral Salpingo-Oophorectomy. Sexual intercourse remains possible after salpingectomy, surgical and radiological cancer treatments, and chemotherapy. Reconstructive surgery remains an option for women who have experienced benign and malignant conditions.

History

Salpingectomies were performed in the United States in the early 20th century in accordance with eugenics legislation. From ''

Buck v. Bell ''Buck v. Bell'', 274 U.S. 200 (1927), is a decision of the United States Supreme Court, written by Justice Oliver Wendell Holmes, Jr., in which the Court ruled that a state statute permitting compulsory sterilization of the unfit, including th ...

'' (1927): ''Buck v. Bell'', while not expressly overturned, was implicitly overturned by '' Skinner v. Oklahoma'' (1942), in which the Court held that a person's choices whether to aid in the propagation of the human species was a cognizable fundamental right guaranteed under the 14th Amendment of the Constitution, a liberty retained by the people under the 9th Amendment of the Constitution.

References