Laparoscopic surgery of the fallopian tubes and ovaries.

Operative laparoscopy can be used for many surgical procedures on the fallopian tube and ovary. These include: (1) tubal sterilization; (2) salpingectomy and salpingostomy for tubal pregnancy; (3) fimbrioplasty, salpingoneostomy, and linear salpingostomy for tubal obstruction and infertility; (4) microsurgical tubal reanastomosis for reversal of tubal sterilization; (5) oophorectomy, cystectomy, cyst drainage and fulguration, and excision of ovarian tumors; (6) wedge resection and ovarian drilling for polycystic ovaries; and (7) fulguration and laser vaporization for endometriosis. Many of these procedures are conservative and involve reconstruction of the tube and ovaries to preserve fertility. Microsurgical techniques are incorporated into such fertility sparing or enhancing procedures. Comparison of similar surgical procedures on the tube and ovaries indicates better or similar surgical outcome when done through the laparoscope rather than laparotomy; less blood loss, faster recovery, and cheaper cost are the hallmarks when the procedure is done by laparoscopy. With further improvement and expansion in laparoscopy equipment, it can be expected that more surgical procedures on the adnexa can be undertaken safely and effectively.