Surgical Options For Blocked Fallopian Tubes

A blocked fallopian tube can prevent the passage of the egg to the sperm, the sperm to the egg, or the fertilized ovum (egg) to the uterus. Fertilization typically occurs within the fallopian tubes and such tubes connect the ovary and the uterus hence, they are very important for natural conception.

The generally accepted method of unblocking fallopian tubes is through tubal surgery which can be done through microsurgical techniques either during open abdominal surgery (laparotomy) or using laparoscopy through a small incision in the abdomen. The latter procedure however must be conducted by a surgeon trained in the field of microsurgery and has hands-on knowledge of laparoscopy.

There are many different surgery techniques for unblocking fallopian tubes and the differences generally involve the length of the incision, the area affected, the type of blockage present, and the method of unblocking applied (e.g. complete removal or creation of another opening).

Tubal reanastomosis involves the complete removal of the blocked portion of the tube and a subsequent joining of the healthy ends. This procedure is usually done with laparotomy or abdominal incision.

Salpingectomy involves the surgical removal of the infected or blocked fallopian tube. It is usually done on patients who have a hydrosalpinx and want to improve their chances at pregnancy through in vitro fertilization (IVF). This procedure is preferred over salpingostomy which is another surgical procedure available for dealing with hydrosalpinges (fluid-filled blocked fallopian tubes).

Salpingostomy is a procedure that requires an incision through the affected fallopian tube. In neosalpingostomy, the idea is to create a new opening in the part of the tube closest to the ovary while in linear salpingostomy the incision serves as the pathway to release the blockage. Neosalpingostomy is generally used in dealing with hydrosalpinges. This technique however more often than not merely provides temporary unblocking as it is a common occurrence for scar tissue growth to reseal the new opening created by neosalpingostomy thereby effectively blocking of the tube once more.

When the problem is a partial blockage or a scarring in the fimbriae (fingerlike projections at the end of the fallopian tube near the ovary), Fimbrioplasty is an option where the blockage or the scar adhesions are removed and the fringed ends are rebuilt such that wafting motion of the fimbriae are restored. The fimbriae move in sweeping motions such that the egg released by the ovary will be caught then guided towards the uterus.

The relative success of the surgery will depend on the health and condition of the patient and the location of the blockage. It is shown that clearing blockages near the uterus are more likely to be successful. Furthermore, the amount of tube that remains after the surgery will determine the ability of the tube to regain its normal function and hence, the subsequent ability of the woman to get pregnant.

Surgery is generally an invasive form of treatment but recent technologies already provide for less invasive procedures as against the traditional open abdominal option such as Laparoscopy. It involves the use of a laparoscope (camera or ultrasound) which is inserted into a small incision through the abdominal wall. The body part requiring surgical treatment will be seen through a monitor which, is connected to the laparoscope.

Surgery procedures also involve risks some of which are spread of pelvic infection, the formation of scar adhesions among the reproductive organs or with the abdominal cavity, and the increase in the possibility of tubal ectopic pregnancy.

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