Gynecological microsurgery in perspective.

Microsurgery provides many advantages over previous conventional methods of surgery in tubal reconstructive work. Microsurgery involves the useof magnification careful tissue handling and microcoagulation to minimize tissue destruction. Meticulous hemostasis and exact approximation of luminal structures are also important. Microsurgical skills are acquired only through years of surgical experience and clinical maturity provided by a well balanced training program. Prospective patients for tubal microsurgery should be carefully screened and selected as sterilization is a permanent procedure and the chance of reversal is small. Microsurgery compared with macrosurgery appears to be of limited value in salpingolysis and salpingostomy but of great value in improving results of salpingostomy and end-to-end anastomosis. A classification for corrective operation of tuboperitoneal factors causing infertility is presented (includes lysis of adhesions fimbrioplasty salpingostomy and tubotubal anastomosis). Limitations of microsurgery are also discussed.