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Robot-assisted laparoscopic tubal anastomosis following sterilization
Female sterilization is the most common method of contraception worldwide, and the second most common contraceptive method used in the United States. Approximately 643,000 sterilization procedures are performed annually.1 Approximately 1% to 3% of women who undergo sterilization will subsequently undergo a sterilization reversal.2 Although multiple variables have been identified, change in marital status is the most commonly cited reason for desiring a tubal reversal.3,4 Tubal anastomosis can be a technically challenging surgical procedure when done by laparoscopy, especially given the microsurgical elements that are required. Several modifications, including limiting the number of sutures, have evolved as a result of its tedious nature.5 By leveraging 3D magnification, articulating instruments, and tremor filtration, it is only natural that robotic surgery has been applied to tubal anastomosis.
In this video, we review some background information surrounding a tubal reversal, followed by demonstration of a robotic interpretation of a 2-stitch anastomosis technique in a patient who successfully conceived and delivered.6 Overall robot-assisted laparoscopic tubal anastomosis is a feasible and safe option for women who desire reversal of surgical sterilization, with pregnancy and live-birth rates comparable to those observed when an open technique is utilized.7 I hope that you will find this video beneficial to your clinical practice.
- Chan LM, Westhoff CL. Tubal sterilization trends in the United States. Fertil Steril. 2010;94:1-6.
- Moss CC. Sterilization: a review and update. Obstet Gynecol Clin North Am. 2015-12-01;42:713-724.
- Gordts S, Campo R, Puttemans P, Gordts S. Clinical factors determining pregnancy outcome after microsurgical tubal anastomosis. Fertil Steril. 2009;92:1198-1202.
- Chi I-C, Jones DB. Incidence, risk factors, and prevention of poststerilization regret in women. Obstet Gynecol Surv. 1994;49:722-732.
- Dubuisson JB, Swolin K. Laparoscopic tubal anastomosis (the one stitch technique): preliminary results. Human Reprod. 1995;10:2044-2046.
- Bissonnette FCA, Lapensee L, Bouzayen R. Outpatient laparoscopic tubal anastomosis and subsequent fertility. Fertil Steril. 1999;72:549-552.
- Caillet M, Vandromme J, Rozenberg S, Paesmans M, Germay O, Degueldre M. Robotically assisted laparoscopic microsurgical tubal anastomosis: a retrospective study. Fertil Steril. 2010;94:1844-1847.
Female sterilization is the most common method of contraception worldwide, and the second most common contraceptive method used in the United States. Approximately 643,000 sterilization procedures are performed annually.1 Approximately 1% to 3% of women who undergo sterilization will subsequently undergo a sterilization reversal.2 Although multiple variables have been identified, change in marital status is the most commonly cited reason for desiring a tubal reversal.3,4 Tubal anastomosis can be a technically challenging surgical procedure when done by laparoscopy, especially given the microsurgical elements that are required. Several modifications, including limiting the number of sutures, have evolved as a result of its tedious nature.5 By leveraging 3D magnification, articulating instruments, and tremor filtration, it is only natural that robotic surgery has been applied to tubal anastomosis.
In this video, we review some background information surrounding a tubal reversal, followed by demonstration of a robotic interpretation of a 2-stitch anastomosis technique in a patient who successfully conceived and delivered.6 Overall robot-assisted laparoscopic tubal anastomosis is a feasible and safe option for women who desire reversal of surgical sterilization, with pregnancy and live-birth rates comparable to those observed when an open technique is utilized.7 I hope that you will find this video beneficial to your clinical practice.
Female sterilization is the most common method of contraception worldwide, and the second most common contraceptive method used in the United States. Approximately 643,000 sterilization procedures are performed annually.1 Approximately 1% to 3% of women who undergo sterilization will subsequently undergo a sterilization reversal.2 Although multiple variables have been identified, change in marital status is the most commonly cited reason for desiring a tubal reversal.3,4 Tubal anastomosis can be a technically challenging surgical procedure when done by laparoscopy, especially given the microsurgical elements that are required. Several modifications, including limiting the number of sutures, have evolved as a result of its tedious nature.5 By leveraging 3D magnification, articulating instruments, and tremor filtration, it is only natural that robotic surgery has been applied to tubal anastomosis.
In this video, we review some background information surrounding a tubal reversal, followed by demonstration of a robotic interpretation of a 2-stitch anastomosis technique in a patient who successfully conceived and delivered.6 Overall robot-assisted laparoscopic tubal anastomosis is a feasible and safe option for women who desire reversal of surgical sterilization, with pregnancy and live-birth rates comparable to those observed when an open technique is utilized.7 I hope that you will find this video beneficial to your clinical practice.
- Chan LM, Westhoff CL. Tubal sterilization trends in the United States. Fertil Steril. 2010;94:1-6.
- Moss CC. Sterilization: a review and update. Obstet Gynecol Clin North Am. 2015-12-01;42:713-724.
- Gordts S, Campo R, Puttemans P, Gordts S. Clinical factors determining pregnancy outcome after microsurgical tubal anastomosis. Fertil Steril. 2009;92:1198-1202.
- Chi I-C, Jones DB. Incidence, risk factors, and prevention of poststerilization regret in women. Obstet Gynecol Surv. 1994;49:722-732.
- Dubuisson JB, Swolin K. Laparoscopic tubal anastomosis (the one stitch technique): preliminary results. Human Reprod. 1995;10:2044-2046.
- Bissonnette FCA, Lapensee L, Bouzayen R. Outpatient laparoscopic tubal anastomosis and subsequent fertility. Fertil Steril. 1999;72:549-552.
- Caillet M, Vandromme J, Rozenberg S, Paesmans M, Germay O, Degueldre M. Robotically assisted laparoscopic microsurgical tubal anastomosis: a retrospective study. Fertil Steril. 2010;94:1844-1847.
- Chan LM, Westhoff CL. Tubal sterilization trends in the United States. Fertil Steril. 2010;94:1-6.
- Moss CC. Sterilization: a review and update. Obstet Gynecol Clin North Am. 2015-12-01;42:713-724.
- Gordts S, Campo R, Puttemans P, Gordts S. Clinical factors determining pregnancy outcome after microsurgical tubal anastomosis. Fertil Steril. 2009;92:1198-1202.
- Chi I-C, Jones DB. Incidence, risk factors, and prevention of poststerilization regret in women. Obstet Gynecol Surv. 1994;49:722-732.
- Dubuisson JB, Swolin K. Laparoscopic tubal anastomosis (the one stitch technique): preliminary results. Human Reprod. 1995;10:2044-2046.
- Bissonnette FCA, Lapensee L, Bouzayen R. Outpatient laparoscopic tubal anastomosis and subsequent fertility. Fertil Steril. 1999;72:549-552.
- Caillet M, Vandromme J, Rozenberg S, Paesmans M, Germay O, Degueldre M. Robotically assisted laparoscopic microsurgical tubal anastomosis: a retrospective study. Fertil Steril. 2010;94:1844-1847.
Excision of a Bartholin gland cyst
Bartholin gland cysts comprise up to 2% of all outpatient gynecology visits each year1 and are a common consult for trainees in obstetrics and gynecology. Although excision of a Bartholin gland cyst is a procedure performed infrequently, knowledge of its anatomy and physiology is important for ObGyn trainees and practicing gynecologists, especially when attempts at conservative management have been exhausted.
Before proceeding with surgical excision, it is important to understand the basics of Bartholin gland anatomy, pathologies, and treatment options. This video demonstrates the excisional technique for a 46-year-old woman with a recurrent, symptomatic Bartholin gland cyst who failed prior conservative management. I hope that you will find this video from my colleagues beneficial to your clinical practice.
- Marzano DA, Haefner HK. The bartholin gland cyst: past, present, and future. J Low Genit Tract Dis. 2004;8(3):195–204.
Bartholin gland cysts comprise up to 2% of all outpatient gynecology visits each year1 and are a common consult for trainees in obstetrics and gynecology. Although excision of a Bartholin gland cyst is a procedure performed infrequently, knowledge of its anatomy and physiology is important for ObGyn trainees and practicing gynecologists, especially when attempts at conservative management have been exhausted.
Before proceeding with surgical excision, it is important to understand the basics of Bartholin gland anatomy, pathologies, and treatment options. This video demonstrates the excisional technique for a 46-year-old woman with a recurrent, symptomatic Bartholin gland cyst who failed prior conservative management. I hope that you will find this video from my colleagues beneficial to your clinical practice.
Bartholin gland cysts comprise up to 2% of all outpatient gynecology visits each year1 and are a common consult for trainees in obstetrics and gynecology. Although excision of a Bartholin gland cyst is a procedure performed infrequently, knowledge of its anatomy and physiology is important for ObGyn trainees and practicing gynecologists, especially when attempts at conservative management have been exhausted.
Before proceeding with surgical excision, it is important to understand the basics of Bartholin gland anatomy, pathologies, and treatment options. This video demonstrates the excisional technique for a 46-year-old woman with a recurrent, symptomatic Bartholin gland cyst who failed prior conservative management. I hope that you will find this video from my colleagues beneficial to your clinical practice.
- Marzano DA, Haefner HK. The bartholin gland cyst: past, present, and future. J Low Genit Tract Dis. 2004;8(3):195–204.
- Marzano DA, Haefner HK. The bartholin gland cyst: past, present, and future. J Low Genit Tract Dis. 2004;8(3):195–204.
