Reconstructive tubal microsurgery and assisted reproductive technology

Victor Gomel, M.D., F.R.C.S.C

Volume 105, Issue 4, Pages 887-890


For the infertile woman with tubal damage, there are only two realistic options for achieving a pregnancy: reconstructive surgery or in vitro fertilization (IVF). Until the 1980s, reconstructive surgery was the only therapeutic option for infertility caused by tubal and peritoneal factors. Traditional techniques yielded poor outcomes, often as a result of extensive postoperative adhesions. This led to the development of gynecologic microsurgery in the early 1970s. In addition to the use of magnification, microsurgery introduced a broad concept of surgery designed to be more precise, to minimize trauma and tissue damage, and to avoid an acute inflammatory reaction in the peritoneal cavity to obtain better results and prevent postoperative adhesions.

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