Tubal Reconstruction

ligationFallopian tubes are tubular passages that connect endometrium in the uterine cavity to peritoneal cavity. After ovulation the ovum is captured by fallopian tubes and serves as a passage for its journey to the uterus. Fertilization of the egg by the sperm takes place in the fallopian tube. The embryo so developed continues its travel to the uterine cavity through the fallopian tubes. In the uterine cavity the embryo gets implanted in the endometrium. Ovum and the embryo is not having any intrinsic mobility. Fallopian tube functions as a passage and transporter of the ovum and the embryo. Fallopian tube also helps the sperm to travel to the spot of fertilization. Thus the existence of fallopian tubes is a prerequisite for normal pregnancy in a woman. Functions of fallopian tube can be disrupted by various infections and diseases which may end up in infertility and in severe cases it may lead to sterility also. Reconstruction of fallopian tube is the traditional treatment option for fallopian tube problems.
Today latest techniques like in vitro fertilization and embryo transfer have opened new avenues for patients suffering from fallopian tube problems.
Similarly reconstruction of fallopian tube may be necessary in cases where the patients who have earlier undergone permanent sterilization by tubal ligation, now feels the necessity of reversing the earlier condition. The intention of tubal reconstruction also known as tubal anasthamosis is to make necessary repairs in the tube so that the ability for conceiving is restored. First case of tubal reconstruction was reported in the year 1896 though the result was dismal. Overtime, positive improvements in the surgical field which includes advancement in the surgical techniques, operative care, laparoscopic procedures, understanding of fallopian tube physiology etc have made the reconstruction of fallopian tubes as a better option compared to the difficulty and expenses of in vitro fertilization and embryo and embryo transfer.

Laparoscopic procedure

Laparoscopic procedure are also known as minimally invasive procedure as only three or four small incision of the size of one or two cms are needed in this case as against the need of a long incision of the size 6 to 8 inches needed in the open surgery. Through one of these incisions a laparoscope which is an instrument used to take the video of the surgery being carried out is inserted. The videos taken by this camera are displayed in a monitor placed in front of the surgeon who is carrying out the surgery. Other special instruments used for carrying out the surgery are inserted through other small incisions of the similar type near the above mentioned incision. The surgeon carries out the surgery watching the video in the monitor and controlling the instruments remotely with his hands. Before starting the surgical procedure, carbon dioxide gas is pumped to the abdominal area to inflate it so that extra space is obtained for carrying out the surgical procedures and the internal organs can be viewed clearly. After completing the surgical procedures the instruments and camera are withdrawn and the incisions are closed by stitching or by using surgical strips intended for this purpose.

Peculiarities of laparoscopic procedure

  1.  As the incisions are smaller, the pain will be lesser and the healing is faster.
  2. The patient will be able to return to his normal activities at a faster pace.
  3. The scars will not be visible after healing as the incisions are smaller.
  4.  Obese person and diabetics are not considered for laparoscopic procedure.
  5. A person who has earlier undergone a surgical procedure in the target area are not usually considered as suitable candidate for laparoscopic procedure.