Robot-assisted tubo-tubal reanastomosis after sterilization in 10 steps

J Gynecol Obstet Hum Reprod. 2023 Jun;52(6):102605. doi: 10.1016/j.jogoh.2023.102605. Epub 2023 May 18.

Abstract

Five to 20% of women regret having a tubal ligation. These women are generally otherwise fertile and have a better chance of pregnancy than other patients experiencing infertility, whether by in vitro fertilization or after tubal surgery. Historically, tubal anastomosis surgery has long been performed by microsurgery through laparotomy, which provided very high precision but was associated with some degree of morbidity. The parallel development of in vitro fertilization and laparoscopy have contributed to reducing the indications for tubal surgery. The laparoscopic approach is challenging because of the number and precision of the sutures needed. The robot-assisted laparoscopic approach may reduce the surgical difficulty and improve the accessibility of this technique. We have described the technique of tubo-tubal reanastomosis after sterilization with robot-assisted laparoscopy in 10 steps. Robot-assisted laparoscopy provides favourable conditions for performing tubo-tubal reanastomosis after sterilization due to the camera stability, precision of movement, and amplitude of articulations.

Keywords: Robot-assisted laparoscopy; Sterilization; Tubo-tubal reanastomosis.

MeSH terms

  • Fallopian Tubes / surgery
  • Female
  • Humans
  • Pregnancy
  • Robotics*
  • Sterilization
  • Sterilization Reversal / methods
  • Sterilization, Tubal* / methods