Fallopian
Tubes
and Ovaries
Laparoscopy
Technique
Diagnostic
Uses
of Laparoscopy
Demonstration
of Tubal Patency
via Laparoscopy
Laparoscopic
Resection
of Unruptured
Ectopic Pregnancy
Ovarian
Biopsy
via Laparoscopy
Electrocoagulation
of
Endometriosis via
Laparoscopy
Lysis
or Adhesions
via Laparoscopy
Control
of Hemorrhage
During Laparoscopy
Sterilization
by
Electrocoagulation and
Division via Laparoscopy
Silastic
Band Sterilization
via Laparoscopy
Hulka
Clip Sterilization
via Laparoscopy
Sterilization
by the
Pomeroy Operation
Sterilization
by the
Modified Irving Technique
Sterilization
by the
Minilaparotomy Technique
Salpingectomy
Salpingo-oophorectomy
Fimbrioplasy
Tuboplasty
-
Microresection
and Anastomosis
of the Fallopian Tube
Wedge
Resection
of the Ovary
Torsion
of the Ovary
Ovarian
Cystectomy
Fallopian
Tube
Sterilization |
Salpingectomy
The most frequent indication for salpingectomy is ectopic
pregnancy, but the operation is also performed in isolated cases of
inflammatory disease with a unilateral hydrosalpinx.
The purpose of
the operation is to remove the Fallopian tube while leaving the uterus
and ovary intact.
Physiologic Changes. The
Fallopian tube is removed.
Points of Caution. The cornual portion of the Fallopian
tube and mesosalpinx are extremely vascular areas. Hemostasis must
be insured.
Technique
A laparotomy is performed through a tranverse
or midline incision. The diseased tube is identified and freed
of all peritubal adhesions. The cornual portion of the tube is
clamped with a Kelly clamp, and the remainder is grasped with
a Babcock clamp and elevated into a convenient position. Repeated
fenestrations in the mesosalpinx are performed with a straight
Halsted clamp. These should be clamped between small hemostats,
and the tube can be excised from the cornual portion across the
mesosalpinx to the fimbria. |
Each of the pedicles in the hemostats should
be tied with interrupted 3-0 synthetic absorbable suture. The
peritoneal lining is reestablished, and the cornual portion of
the tube is buried with an interrupted 3-0 mattress suture in
the broad ligament into the posterior segment of the uterine
cornu. |
The mesosalpinx is reperitonealized with
a running 3-0 synthetic absorbable suture. |
The mesosalpinx has been closed
with a running 3-0 synthetic absorbable suture. The procedure
has been completed. The abdomen is closed in routine fashion. |
|
