TY - JOUR
T1 - Laparoscopic tubal reanastomosis using robotics
T2 - Experience from a teaching institution
AU - Vlahos, Nikos F.
AU - Bankowski, Brandon J.
AU - King, Jeremy A.
AU - Shiller, Dianne A.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/4
Y1 - 2007/4
N2 - Purpose: Tubal reanastomosis typically requires a laparotomy and in the past few years has been performed much less frequently due to the development and success of in vitro fertilization. Laparoscopic tubal anastomosis eliminates the need for laparotomy and can be performed in an outpatient setting. Materials and Methods: From October 2003 to September 2004, five patients who had previous tubal sterilization and requested tubal reanastomosis underwent laparoscopic tubal reanastomosis with the use of the da Vinci surgical system (Intuitive Surgical, Mountain View, CA). Results: Ten fallopian tubes were successfully reconstructed, as confirmed by chromopertubation at the end of the procedure. Patency was confirmed by hysterosalpingogram in seven out of eight tubes. The mean (± standard deviation) time of the procedure was 172 ± 53 min. The mean time for docking the robotic arms to the patient was 62 ± 16.8 min and the mean robotic time was 97 ± 36 min. There were two live births, one ectopic pregnancy, and one biochemical pregnancy. The mean time to conception was 5.5 ± 2 months. Conclusion: Laparoscopic microsurgical tubal reanastomosis after tubal sterilization can be performed using a remote-controlled robotic system. Systematization of the operative steps allowed for operative times that compare favorably with the time needed for open microsurgical techniques. Larger series are needed to standardize the procedure and confirm postoperative fecundity rates.
AB - Purpose: Tubal reanastomosis typically requires a laparotomy and in the past few years has been performed much less frequently due to the development and success of in vitro fertilization. Laparoscopic tubal anastomosis eliminates the need for laparotomy and can be performed in an outpatient setting. Materials and Methods: From October 2003 to September 2004, five patients who had previous tubal sterilization and requested tubal reanastomosis underwent laparoscopic tubal reanastomosis with the use of the da Vinci surgical system (Intuitive Surgical, Mountain View, CA). Results: Ten fallopian tubes were successfully reconstructed, as confirmed by chromopertubation at the end of the procedure. Patency was confirmed by hysterosalpingogram in seven out of eight tubes. The mean (± standard deviation) time of the procedure was 172 ± 53 min. The mean time for docking the robotic arms to the patient was 62 ± 16.8 min and the mean robotic time was 97 ± 36 min. There were two live births, one ectopic pregnancy, and one biochemical pregnancy. The mean time to conception was 5.5 ± 2 months. Conclusion: Laparoscopic microsurgical tubal reanastomosis after tubal sterilization can be performed using a remote-controlled robotic system. Systematization of the operative steps allowed for operative times that compare favorably with the time needed for open microsurgical techniques. Larger series are needed to standardize the procedure and confirm postoperative fecundity rates.
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U2 - 10.1089/lap.2006.0035
DO - 10.1089/lap.2006.0035
M3 - Article
C2 - 17484644
AN - SCOPUS:34247553657
SN - 1092-6429
VL - 17
SP - 180
EP - 185
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques
JF - Journal of Laparoendoscopic and Advanced Surgical Techniques
IS - 2
ER -