Laparoscopic salpingostomy

Laparoscopic salpingostomy according to M. Bruat with manual stitching

Laparoscopic salpingostomy according to M. Bruat with manual stitching.
Professor Puchkov K.V. is performing an operation (2017).

A 29 year-old patient is operated on for the secondary infertility on the background of chronic salpingitis and left hydrosalpinx. During operation chromosalpingoscopy has been performed, and during this procedure obstruction of the left fallopian tube in its terminal part has been found out, the same thing in the right tube as peritubary adhesion has been present. Salpingoovariolysis has been performed both sides. The video presents the technique of salpingostomy according to M. Bruat. Fixation of fibrial part of fallopian tube is done by placing an atraumatic suture, using resorbable “Polysorb” 4-0 thread, forming an intracorporeal knot. Then a careful washing of operation zone is done by saline solution and introduction of anticommissural gel. Operation time is 40 minutes.

Laparoscopic creation of anastomosis of the fallopian tube

Laparoscopic creation of anastomosis of the fallopian tube.
Professor Puchkov K.V. is performing an operation (2017).

The video demonstrates the technique of laparoscopic creation of the «end-to-end» anastomosis of the left fallopian tube after sterilization. The patient underwent ligation of the single uterine tube at caesarean section in 2012. Surgical intervention was performed at the insistent request of the patient due to the impossibility of IVF on religious grounds. At the first stage, hysteroscopy was performed, in which the uterine cavity and the proximal part of the left fallopian tube were found to be satisfactory. Further, during laparoscopy, a stump of a tube about 2 cm long and a defect of a wall about 1.5 cm was revealed. Single planar adhesions around the tube, fimbria was absolutely free. Tubal stumps are dissected with sharp endoscopic scissors. When checking the functionality of the distal tube, free flow of contrast into the abdominal cavity is noted. An «end to end» anastomosis was created with interrupted sutures with atraumatic Polysorb 5/0 thread without taking of the mucous membrane. Next, excised retrocervical invasive endometriosis from sacral ligaments. The operation time is 55 minutes.
1 year after surgery, the patient reported about 16 week uterine pregnancy.

You can read more about the techniques on the personal site of Professor Konstantin Viktorovich Puchkov.