Laparoscopic treatment of extensive pelvic adhesions, including hydrosalpinx.

Hans H. Reich, H Reich, Reich H
The Journal of reproductive medicine · 1987 · vol. 32(10) , pp. 736–42 · PMID:2960807 · W64754144
article OA: closed CC0 ⤵ 10 in-corpus citations
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Laparoscopic surgery using innovative techniques effectively treated extensive pelvic adhesions, including hydrosalpinx, with high viable pregnancy rates and minimal complications, outperforming laparotomy in similar cases.

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Abstract

Sixty-seven women with extensive pelvic adhesions, including hydrosalpinx, underwent a laparoscopic surgical procedure over the past eight years. Only cases in which ovum pickup was greatly impaired by adhesions were included. Cases of extensive endometriosis or acute adhesions were excluded. Recent innovations in technique were used, including aquadissection, electrodissection, scissors dissection and laparoscopic suturing. Two women suffered transient unilateral brachial plexus injury; there were no other complications. No laparotomies were required. The viable pregnancy rate was 78% (21 of 27) for women who underwent salpingoovariolysis on the most favorable adnexa and 28.5% (2 of 7) for those with salpingostomy for hydrosalpinx. There was one ectopic pregnancy (3%). The outcome for 34 laparoscopically treated women compared favorably with that for 30 women with similar tubal factor infertility who were treated with laparotomy microsurgery; the viable pregnancy rate was 75% (9 of 12) for laparotomy salpingoovariolysis and 53% (8 of 15) for laparotomy salpingostomy, with an ectopic rate of 13% (4 of 30).

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Condition tags

endometriosisinfertility

MeSH descriptors

Adnexal Diseases Fallopian Tube Diseases Laparoscopy Adnexal Diseases Adult Fallopian Tube Diseases Female Humans Laparotomy Salpingostomy Suture Techniques Tissue Adhesions Tissue Adhesions

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