Abstract

PIP: Microsurgery is a techniqe whereby visual acuity is increased through the use of a microscope or other optical magnifying device. Because of the delicate nature of this procedure, an experienced surgeon does not necessarily make a good microsurgeon. A good microsurgeon should be able to consistently reanastomose 1 to 2 mm vessels. The technique is learned through constant practice on laboratory animals. A special attitude and demeanor toward microsurgical techniques is also important for success. Microsurgery of the fallopian tube should be done only under special conditions, and using special microsurgical instruments and equipments. Before tubal plastic surgery is considered, 2 issues must first be resolved: 1) if there is any other cause for the infertility, and 2) if tubal plastic surgery is indicated for the patient at this time. Before tubal surgery is performed, the following conditions must be met: 1) semen analysis must be met, or couple must agree to artificial insemination using a donor; 2) female should have either spontaneous or induced ovulatory cycle; and 3) couple must understand possibility of failure, overall success rate, and sequelae of ectopic pregnancy. Couple must also agree to preoperative investigation of the tube. General tubal techniques include hysterosalpingography, laparoscopy, and hydrotubation. Also discussed are implantation, fimbriolysis, fimbrioplasty, and salpingostomy.