Laparoscopic Tubal Surgery and Adhesiolysis

John S. Hesla, John A. Rock
In: Practical Manual of Operative Laparoscopy and Hysteroscopy · 1997 · pp. 120–132 · doi:10.1007/978-1-4612-1886-9_13 · W1560184434
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-13 ⓘ

Operative laparoscopy has advanced reconstructive procedures, supplanting open abdominal surgery due to equivalent outcomes and lower morbidity, by fulfilling microsurgical tenets with excellent visualization and precise dissection.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This chapter describes laparoscopic approaches to reconstructive pelvic surgery, focusing on tubal surgery and adhesiolysis, emphasizing how operative laparoscopy can correct pelvic pathology using methods designed to mirror microsurgery. It discusses high-level procedural principles such as precise dissection and plane approximation with minimal adjacent-tissue damage, atraumatic instrument use, frequent irrigation to keep serosal surfaces moist, meticulous hemostasis, and limiting foreign-body introduction into the peritoneal cavity. The main limitation is that the chapter is largely instructional/review narrative rather than presenting new patient-level outcomes data in the provided text. Relevance to endometriosis: it does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match for operative laparoscopy and pelvic adhesiolysis.

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Abstract

Major advances in instrument design during the past two decades have allowed the development of endoscopie techniques for correction of pelvic pathology. These reconstructive procedures are in many circumstances supplanting traditional open abdominal microsurgery because of equivalence in outcomes and lower patient morbidity and expense. Operative laparoscopy provides excellent visualization and, when performed properly, fulfills the major tenets of microsurgery. These principles include the precise dissection and approxima-tion of planes with minimal damage to adjacent tissue, use of atraumatic instruments, frequent irrigation to maintain serosal surface moisture, meticulous hemostasis, and minimal introduction of foreign bodies such as glove powder and lint into the peritoneal cavity. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

Reich H. Laparoscopic treatment of extensive pelvic adhesions, including hydrosalpinx. J Re-prod Med. 1987;32:736–742. Gomel V. Salpingo-ovariolysis by laparoscopy in infertility. Fertil Steril. 1983;40:607–611. Rock JA, Katayama P, Martin EJ, et al. Factors influencing the success of salpingostomy techniques for distal fimbrial obstruction. Obstet Gynecol. 1978;52:591–596. Nezhat C, Winer WK, Cooper JD, et al. Endoscopic infertility surgery. J Reprod Med. 1989; 34:127–134. McComb PF, Paleologou A. The intussusception salpingostomy technique for the therapy of distal oviductal occlusion at laparoscopy. Obstet Gynecol. 1991;78:443–447. Dlugi AM, Reddy S, Saleh WA, et al. Pregnancy rates after operative endoscopic treatment of total (neosalpingostomy) or near total (salpingostomy) distal tubal occlusion. Fertil Steril. 1994;62:913–920. Canis M, Mage G, Pouly JL, Manhes H, et al. Laparoscopic distal tuboplasty: report of 87 cases and a 4-year experience. Fertil Steril. 1991;56: 616–621. Dubuisson JB, Chapron C, Morice P, et al. Laparoscopic salpingostomy: fertility results according to the tubal mucosal appearance. Hum Re-prod. 1994;9:334–339. Holst N, Maltau JM, Forsdahl F, Hansen LJ. Handling of tubal infertility after introduction of in vitro fertilization: changes and consequences. Fertil Steril. 1991;55:140–143. Tan SL, Royston P, Campbell S, et al. Cumulative conception and live birth rates after in-vitro fertilization. Lancet. 1992;339:1390–1394. Editor information Editors and Affiliations Rights and permissions Copyright information © 1997 Springer Science+Business Media New York About this chapter Cite this chapter Hesla, J.S., Rock, J.A. (1997). Laparoscopic Tubal Surgery and Adhesiolysis. In: Azziz, R., Murphy, A.A. (eds) Practical Manual of Operative Laparoscopy and Hysteroscopy. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1886-9_13 Download citation DOI: https://doi.org/10.1007/978-1-4612-1886-9_13 Publisher Name: Springer, New York, NY Print ISBN: 978-1-4612-7324-0 Online ISBN: 978-1-4612-1886-9 eBook Packages: Springer Book Archive

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