Principles of tubal surgery
Epublication WebSurg.com, Feb 2015;15(02). URL: http://websurg.com/doi/lt03enwatrelot008
This presentation focuses on the specific advantages of tubal surgery as compared to assisted reproductive techniques (ART). Tubal surgery is a valid option in selected cases. This selection is only possible through endoscopy and a precise knowledge of lesions is necessary. Three kinds of lesions have to be precisely known: pelvic adhesions and tubal lesions, either distal or proximal. Nowadays, a special focus has to be made on subtle tubal lesions which were underestimated until recently. Diagnosis and patient selection is a key factor and it is best achieved through transvaginal endoscopy such as fertiloscopy. Even if today laparoscopy is the gold standard to treat tubal abnormalities, the principles of microsurgery which were defined a long time ago have to be strictly applied if one wants to get a pregnancy rate equivalent or superior to what is expected with in vitro fertilization (IVF).