On the reanastomosis of fallopian tubes after surgical sterilization.

A macrosurgical technique for tubal reanastomosis is described in detail. It has been used successfully on 12 patients in the last year, 10 of whom have already become pregnant. The technique is suitable for different methods of sterilization, sites of anastomosis, and lengths of segments. The procedures are characterized as isthmic-isthmic, isthmic-ampullary, and ampullary-ampullary. 2 patients had isthmic-isthmic operations; both had had Pomeroy sterilizations. Both became pregnant and delivered at term. 7 patients had isthmic-ampullary operations; 2 had had Pomeroy sterilization and 5 had had laparoscopic diathermy. 5 have normal pregnancies at the time of report; the 2 nonpregnant women have at least 1 patent tube. 3 patients had ampullary-ampullary operations; all had had Pomeroy sterilizations involving only the ampulla. All have become pregnant but 1 had a tubal pregnancy distal to the site of the anastomosis, which was somewhat constricted while the other tube was patent. Intervals from operation to pregnancy were 6 and 9 months for isthmic-isthmic; 2, 3, 7, 9, and 10 months for isthmic-ampullary; and 2, 3, and 7 months for ampullary-ampullary. The procedure should be carried out in the proliferative phase of the menstrual cycle.