Salpingectomy refers to the surgical removal of a

fallopian tube The fallopian tubes, also known as uterine tubes, oviducts or salpinges (: salpinx), are paired tubular sex organs in the human female body that stretch from the Ovary, ovaries to the uterus. The fallopian tubes are part of the female reproduct ...

. This may be done to treat an ectopic pregnancy or

cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...

, 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 pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth control only be ...

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

ectopic pregnancies Ectopic pregnancy is a Complications of pregnancy, 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 ...

. For contraceptive purposes, this procedure is an irreversible form of sterilization and more effective than

tubal ligation Tubal ligation (commonly known as having one's "tubes tied") is a surgical procedure for female sterilization in which the fallopian tubes are permanently blocked, clipped or removed. This prevents the fertilization of eggs by sperm and thus the ...

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 (, after the

Latin Latin ( or ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken by the Latins (Italic tribe), Latins in Latium (now known as Lazio), the lower Tiber area aroun ...

word for 'mouth') by surgery would be a ''salpingostomy'', while the incision into the tube to remove an ectopic is a ''salpingotomy''.

Indications

Salpingectomy was performed by Lawson Tait in 1883 in women with a bleeding ectopic pregnancy; it is now established as a routine and lifesaving procedure. Other indications for a salpingectomy include infected tubes (as in a hydrosalpinx) 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. 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 ...

; more recently however,

laparoscopic Laparoscopy () is an operation performed in the abdomen or human pelvis, pelvis using small Surgical incision, incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few ...

salpingectomies have become more common as part of minimally invasive surgery. The tube is severed at the point where it enters the

uterus The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the hollow organ, organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic development, embryonic and prenatal development, f ...

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 ...

, in which one or both

ovaries The ovary () is a gonad in the female reproductive system that produces ova; when released, an ovum travels through the fallopian tube/oviduct into the uterus. There is an ovary on the left and the right side of the body. The ovaries are endocr ...

, 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 Hysterectomy is the surgical removal of the uterus and cervix. Supracervical hysterectomy refers to removal of the uterus while the cervix is spared. These procedures may also involve removal of the ovaries (oophorectomy), fallopian tubes ( salpi ...

(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'' (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