RESUMENAntecedentes: Los avances en las técnicas de cirugía laparoscopia han permitido a cirujanos entrenados realizar reanastomosis tubaria bilateral por laparoscopia, reportando resultados similares a los de la técnica vía laparotómica. Objetivo: Evaluar una nueva técnica de reanastomosis tubaria llamada "técnica de tres puntos". Método: Se realiza estudio retrospectivo que evalúa 5 casos de pacientes con antecedentes de esterilización quirúrgica, a quienes se les realizó reanastomosis tubaria laparoscópica con la técnica de tres puntos. Resultados: La edad promedio de las pacientes fue de 35,8 ± 5,7 años (rango: 26-40 años); 80% (8/10) de las trompas fueron reanastomosadas. En dos pacientes la reanastomosis fue unilateral por segmento distal ausente de la trompa contralateral. El tiempo promedio de duración de la cirugía fue de 150 ± 7,9 minutos (rango: 140-160 minutos). La tasa de embarazo fue de 40% (2/5). Los embarazos se produjeron en las pacientes más jóvenes y con reanastomosis bilateral. En aquellas que no lograron embarazo se realizó histerosalpingografía verificándose el 100% de las trompas reanastomosadas permeables.PALABRAS CLAVE: Reanastomosis tubaria, infertilidad, esterilización, ligadura tubaria, laparoscopia, repermeabilización SUMMARYBackground: Advances in endoscopic surgical techniques have allowed well-trained and skilled surgeons to perform tubal anastomosis by laparoscopy reporting similar results than by laparotomy. Objective: To evaluate a new technique we called "three-stitch method". Method: The outcomes for this evaluation were tubal patency and pregnancy rate. A retrospective analysis of five cases of previous tubal sterilization underwent endoscopic tubal reanastomosis using the "three-stitch technique" was done. In all patients a preoperative hysterosalpingogram was performed to confirm occlusion. Results: The average age was 35.8 ± 5.7 years (rango: 26-40 years). All the patients underwent previous tubal sterilization (four cases using Pomeroy technique and one case with Yoon Ring). Eighty percent (8/10) of tubes were reanastomosed. In two cases, due to inadequate conditions of distal or proximal ends of one tube, surgery was performed on the other only. The average surgical time was 150 ± 7.9 minutes (range 140-160 minutes). The pregnancy rate was 40% (2/5). Pregnancy was achieved in younger patients who underwent bilateral reanastomosis. In those patients where pregnancy was not accomplished, a hysterosalpingography was taken to evaluate tubal patency. All of the reanastomosed tubes showed tubal patency at six months follow-up.
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