Tubal desterilization through exclusive laparoscopy

The 1st case of tubal reversal after use of the Yoon ring by way of exclusive laparoscopy is discussed. Yoon ring tubal segment excision was performed with CO2 laser and coelioscopic scissors after mesosalpinx hemostasis by ornithine-vasopressin infiltration. Tubal anastomosis was managed with biological glue on an intraluminal guide which was pulled out after 48 hours. Follow-up hysterosalpingography 3 months later showed perfect tubal patency. This case proves that complete tubal reversal by exclusive coelioscopy is possible. At present this procedure is restricted to only 1 tube during coelioscopic evaluation preserving in case of failure the chance of microsurgery either on the contralateral tube or even on the previously operated one. The advantages of such a technique are those of coeliosurgery; no laparotomy shortened hospitalization and minimal postoperative adhesions. Since this 1st case others have been performed. It is still too early to appreciate the results in terms of intrauterine pregnancy. (authors)