Reversal of tubal sterilization using laparoscopically placed titanium staples: preliminary experience

We tested the feasibility of performing outpatient laparoscopic surgery to reverse tubal sterilization using titanium staples to reapproximate the oviducts. A total of 14 women underwent the procedure which involved excision of the tubal eschar, stenting of the severed remnants, and circumferential stapling of the muscularis and serosa. Reapproximation was possible in all cases, with a measured tubal length post-anastomosis of 4.5 +/- 0.5 cm (range 3.0-7.0 cm). The length of operating time was 2.8 +/- 0.2 h (range 2.2-3.8 h), and all patients were discharged the same day. There were no operative complications, and no readmissions were necessary. Within 6 months of surgery there were six pregnancies including one spontaneous abortion and five ongoing pregnancies. Of those not conceiving within 8 months, seven (100%) demonstrated tubal patency on a follow-up hysterosalpingogram. We conclude the laparoscopic approach to tubal sterilization reversal is a viable alternative to open abdominal microsurgical approaches. Although preliminary, laparoscopic surgery promises to be cost effective, as it can be performed on an outpatient basis, may reduce operative time and minimizes the recuperative period of patients.