Laparoscopic Tubal Recanalization

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laparoscopic tubal recanalization anastomosis tuboplasty infetility ivf Pradeep Garg New Delhi india aiims fallopian tube Microsurgical Tubal Obstruction Tubal sterilization reversal Tubal Obstruction Sterilization Reversal tuberculosis genital

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Laparoscopic Tubal Recanalization

  1. 1. Laparoscopic Tubal Recanalization Dr. Pradeep Garg Assistant Professor Dept. of Obst. & Gynae All India Institute of Medical Sciences, New Delhi Email:pkgarg_in2004@yahoo.com
  2. 2. Laparoscopic microsurgery is a new discipline that synergizes the potential of classical microsurgery and laparoscopy Introduction Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
  3. 3. Advantages of Laparoscopic Tubal Recanalization <ul><li>All microsurgical principles are well maintained like magnification, tissue handling, haemostasis & lavage </li></ul><ul><li>Avoids laparotomy & tissue trauma associated with packing & retractors </li></ul><ul><li>Minimal tissue handling & trauma </li></ul><ul><li>Adhesions are minimal </li></ul><ul><li>Cosmetically far better </li></ul><ul><li>Faster recovery </li></ul>Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
  4. 4. Indications of Tubal Anastomosis <ul><li>Reversal of tubal sterilization procedure </li></ul><ul><li>Mid-tubal block secondary to various pathology </li></ul><ul><li>Tubal occlusion secondary to ectopic pregnancy treatment </li></ul><ul><li>Salpingitis isthmica nodosa </li></ul><ul><li>Failed tubal cannulation for proximal tubal block </li></ul>Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
  5. 5. Contraindications <ul><li>Aged 40 years or older </li></ul><ul><li>Decreased ovarian reserve or ovarian failure </li></ul><ul><li>Extensive tubal damage </li></ul><ul><li>Hydrosalpinx with a diameter of more than 3 cm </li></ul><ul><li>Inadequate proximal or distal tubal segment for reanastomosis </li></ul><ul><li>Projected tubal length of less than 3 cm after the reconstruction procedure </li></ul><ul><li>Extensive pelvic/peritubal adhesions </li></ul><ul><li>Any contraindication to pregnancy or surgery </li></ul><ul><li>Severe male factor infertility or male sterility </li></ul>Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
  6. 6. Instrumentation <ul><li>High resolution three-chip camera </li></ul><ul><li>Good light source </li></ul><ul><li>High resolution monitor </li></ul><ul><li>Microsurgical hand instruments </li></ul>Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
  7. 7. Chromopertubator and injection needle Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
  8. 8. Suction irrigation cannula and curve monopolar hook Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
  9. 9. Microneedle holder and micrograsping forceps Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
  10. 10. Ultramicro scissors Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
  11. 11. Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi 3.5 mm microtrocars with automatic valve
  12. 12. Movie To see videos on laparoscopic gynae surgeries please logon to www .youtube.com and type Pradeep aiims
  13. 13. Conclusion <ul><li>Laparoscopic microsurgery offers all the benefits of traditional microsurgery coupled with the inherent advantages of laparoscopy </li></ul>Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
  14. 14. <ul><li>For queries mail me at </li></ul><ul><li>pkgarg_in2004@yahoo.com </li></ul>

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