Tuboplasty refers to a number of surgical operations that attempt to restore patency and functioning of the
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 ...
(s) so that a pregnancy could be achieved. As tubal infertility is a common cause of
infertility
In biology, infertility is the inability of a male and female organism to Sexual reproduction, reproduce. It is usually not the natural state of a healthy organism that has reached sexual maturity, so children who have not undergone puberty, whi ...
, tuboplasties were commonly performed prior to the development of effective
in vitro fertilization
In vitro fertilisation (IVF) is a process of fertilisation in which an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating the ovulatory process, then removing an ovum or ova (egg or eggs) from ...
(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'', : 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 ...
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 ...
or
laparoscopy approach.
Techniques include the use of
microsurgery,
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'' originated as an acronym for light amplification by stimulated emission of radi ...
,
electrocautery,
hydrodissection, mechanical
dissection
Dissection (from Latin ' "to cut to pieces"; also called anatomization) is the dismembering of the body of a deceased animal or plant to study its anatomical structure. Autopsy is used in pathology and forensic medicine to determine the cause of ...
, and use of surgical
stents
In medicine, a stent is a tube usually constructed of a metallic alloy or a polymer. It is inserted into the Lumen (anatomy), lumen (hollow space) of an anatomic vessel or duct to keep the passageway open.
Stenting refers to the placement of ...
, hoods, adhesions barriers, and more.
Results depend on the underlying pathology and the skill of the surgeon.
Pregnancy rates 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
References
Gynecological surgery