Fallopian Tube Reanastomosis by Laparotomy versus Laparoscopy: A Meta-Analysis

Grange, J. la; Kruger, Thinus F.; Steyn, D.W.; Merwe, J. P. van der; Siebert, Igno; Matsaseng, Thabo; Viola, M.I.

doi:10.1159/000333355

Cited by 9 publications

(9 citation statements)

References 54 publications

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“…Studies have investigated the method applied, pregnancy rates and the time taken to achieve pregnancy and the pregnancy rates of laparoscopy have been found to be similar to those obtained with laparotomy. [8] In the current study, there was no statistically significant difference in the patient's characteristics in both the groups as shown in Table 1. Live births were achieved in 3 (30%) of the 10 patients to whom laparotomy was applied and in 4 (40%) of the 10 patients to whom laparoscopy was applied.…”

Section: Discussionmentioning

confidence: 48%

“…In an extensive meta-analysis which compared tubal recanalisation with laparotomy and laparoscopy, no difference was determined between the 2 groups in respect of ectopic pregnancy rates. [8] In the current study, ectopic pregnancy occurred in 1 patient of each group. Although, no statistically significant difference was determined as no complications were encountered in the laparoscopy group, this renders it as a first choice.…”

Section: Discussionmentioning

confidence: 58%

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A Comparative Analysis of Laparoscopy v/S Laparotomy for Tubal Recanalisation

Kalpana¹,

Gupta²

2018

jemds

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BACKGROUND Tubal sterilisation is a contraception method widely used throughout the world. The most important reason for the selection of this method is that it is permanent. However, several studies have shown that for various reasons, 1% -3% of couples make the decision for recanalisation. However, the pregnancy rate after surgery is determined by multiple other factors. MATERIALS AND METHODSThis retrospective study included 20 patients who underwent tubal recanalisation surgery in our clinic from January 2012 to July 2017. The patients were separated into 2 groups as Group 1 who underwent laparoscopic recanalisation and Group 2 who underwent laparotomy. A record was made for each patient of the age at sterilisation, the age at recanalisation, previous pelvic surgery, additional diseases (diabetes mellitus [DM], hypertension, thyroid disease, etc.), results of hysterosalpingography (HSG), the sterilisation method applied and the recanalisation method. According to the fertility outcomes after recanalisation, the patients were evaluated in 4 categories as 1= unsuccessful result, 2= abortus, 3= ectopic pregnancy and 4= live birth. RESULTSOf the 20 patients evaluated, no statistically significant difference was determined between the patient's characteristics in both groups. At the end of the 2-year follow-up of the patients who underwent laparoscopic recanalisation no pregnancy had been achieved in 4 (40%), abortus in 1 (10%), ectopic pregnancy in 1 (10%) and a live birth in 4 (40%) cases. In the laparotomic group the 2-year follow-up outcomes were no pregnancy in 4 (40%), abortus in 2 (20%), ectopic pregnancy in 1 (10%) and live birth in 3 (30%) cases. In our study patients of age ≤ 35 years, 80% (4/5) had a live birth in laparoscopy group and 60% (3/5) had live birth in laparotomy group. While patients > 35 years laparoscopy group one (10%) patients conceived, but landed with ectopic pregnancy and in laparotomy group one (10%) patient conceived and landed with abortion. CONCLUSIONTubal recanalisation gives hope to patients to conceive again after sterilisation. However, the success rate is determined by multiple factors. There is no concrete evidence available to support one form of surgery over other. However, laparoscopy has an advantage of being minimally invasive surgery with lesser complications. Hence, laparoscopy is to be preferred over laparotomy. KEYWORDSTubal Recanalisation, Laparoscopy, Laparotomy, Pregnancy Outcome. HOW TO CITE THIS ARTICLE: Kalpana B, Gupta R. A comparative analysis of laparoscopy v/s laparotomy for tubal recanalisation.

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 58%

A Comparative Analysis of Laparoscopy v/S Laparotomy for Tubal Recanalisation

Kalpana¹,

Gupta²

2018

jemds

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“…In some studies, it has been stated that pregnancy rates reach a plateau 3 years after reanstomosis [16]. Studies have also investigated the method applied apart from pregnancy rates and the time taken to achieve pregnancy and the pregnancy rates of laparoscopy have been found to be similar to those obtained with laparotomy [17]. In a study by Cetin et al of 134 patients who had previously undergone tubal sterilisation, comparisons were made of a group with laparoscopic tubal reanastomosis with a group who underwent IVF and the pregnancy rates were found to be higher in the tubal reanastomosis group [18].…”

Section: Discussionmentioning

confidence: 98%

“…Another point which requires evaluation after reanastomosis is the risk of ectopic pregnancy. In an extensive meta-analysis which compared tubal reanastomosis with laparotomy and laparoscopy, no difference was determined between the 2 groups in respect of ectopic pregnancy rates [17]. In studies which have compared tubal reanastomosis and IVF, no difference has been determined in respect of ectopic pregnancy rates.…”

Section: Discussionmentioning

confidence: 99%

Fertility Outcomes After Reversal of Tubal Sterilisation

Seyfettinoğlu¹

2016

Ann Clin Anal Med

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“…Early pregnancy detection and ultrasound evaluation should be done to determine the possibility of ectopic pregnancy. 10 To date, the modern procedure is performed by doing an excision of the tubal segment and reanastomosis by trans-abdominal laparoscopy. Recently, the laparoscopic technology has developed and evolved rapidly as the robotic assisted laparoscopy was invented to assist the surgeon in doing some laparoscopy procedures despite the paucity publications for this procedure.…”

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confidence: 99%

Fertility Outcomes after Laparoscopic Reversal of Tubal Sterilization

Hadisaputra

2016

Indones J Obstet Gynecol

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Objective: To know pregnancy outcome in the tubal reversal of sterilized women. Method: Literature review. Results: Sterilization is considered the most common contraception methods in United States of America, approximately 39% women in reproductive age (15 - 44 years) used this method. However, approximately 15% of these patients deplored this decision due to the influence of their own environment and some factors, such as: young age, the death of a child, the disability of child, and change of partner/ remarried. Tubal reanastomosis or tubal reversal is a surgical procedure that attempts to restore the fallopian tube patency following sterilization. To date, the modern procedure is performed by doing an excision of the tubal segment and reanastomosis by transabdominal laparoscopy. Recently, the laparoscopic technology has developed and evolved rapidly as the robotic assisted laparoscopy was invented. There is alternative method for restoring the fertility in sterilized women who regretted the decision of being sterilized. Unlike the tubal reversal which is conducted in order to restore the tubal function, the IVF is performed to bypass the function of tubes in fertility. The major advantage for laparoscopic surgery is short postoperative stay duration with minimal tissue handling, less postoperative adhesions, and diminish morbidity rate. Despite of its major drawback, high-cost of robotic machine and machine maintenance; there are advantages of robotic laparoscopy compared to the conventional laparoscopy, such as improved dexterity, more precise and accurate articulation, reduced tremor, and better visualization of the operating field. In vitro fertilization (IVF) is the hallmark in the era of assisted reproductive technology and became an alternative option to regain the fertility in sterilized women. Conclusion: The pregnancy rate and live birth rate in laparoscopy, robotic and open surgery were relatively similar. Surgical reversal to women younger than 40 is recommended and laparoscopic reversal should be performed if the expertise is available. It is reasonable to counsel IVF to over 40 women. [Indones J Obstet Gynecol 2012; 36-3: 154-60] Keywords: gynecology, IVF, pregnancy outcomes, reanastomosis, robotic laparoscopy, tubal reversal

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Fallopian Tube Reanastomosis by Laparotomy versus Laparoscopy: A Meta-Analysis

Cited by 9 publications

References 54 publications

A Comparative Analysis of Laparoscopy v/S Laparotomy for Tubal Recanalisation

A Comparative Analysis of Laparoscopy v/S Laparotomy for Tubal Recanalisation

Fertility Outcomes After Reversal of Tubal Sterilisation

Fertility Outcomes after Laparoscopic Reversal of Tubal Sterilization

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