Tubal desterilization through exclusive laparoscopy.

The first case of tubal desterilization after Yoon rings through exclusive laparoscopy is reported. Yoon ring tubal segment excision was performed with CO2 laser and coelioscopic scissors, after mesosalpinx haemostasis by ornithine--vasopressin infiltration. Tubal anastomosis was managed with biological glue on an intraluminal guide which was pulled out after 48 h. 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 one 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 post-operative adhesions. Since this first case, others have been performed. It is still too early to appreciate the results in terms of intrauterine pregnancy.