Page 23 - World Association of Laparoscopic Surgeons - Journal

Bello L Zainab

media and this was supported by falloposcopic in the absence of obstructive disease. These obstacles could
procedures. 10-13 be overcome by using smaller directional guidewire, softer
Schille et al revealed in his studies that proximal tubal distension-free Teflon catheters, improved microendoscopes
blockage which is a major cause of subfertility in women and improved surgical skills necessary for a safe and fruitful
could be easily managed with falloposcopy and this yielded falloposcopy. 16-20 All these studies are revealing the
good pregnancy outcome. 14 Further studies revealed the importance and efficacy of falloposcopy in both diagnosing
importance of falloposcopy in performing tubal cannulation tubal infertility and treating it based on the pathology.
under laparoscopic guidance with both the coaxial and LEC However, falloposcopy has been shown to be a highly
falloposcopes and they achieved 80% success rate. 15 useful, minimally invasive procedure in diagnosing and
Technical difficulties existed with coaxial falloposcopes treating patients with proximal, mid and distal tubal disease
more than with LEC during the procedure and this could be as a cause of their subfertility. It has also being shown from
attributed to ostial spasm secondary to attempted guidewire the aforementioned studies to have a good predictive value
cannulation and inability to negotiate the whole tubal lumen for investigation and future fertility. 21

A B

Figs 2A and B: (A) When methylene blue and silicone (Advanced Medical Grade Silicones BV, The Netherlands) are injected into the
fallopian tube, the obturator tip is held in place by the outer catheter, (B) when the silicone has hardened the inner part of the coaxial
catheter is then withdrawn and breaks the silicone column (which has extended from the syringe to the ampullary part of the plug) at the
junction of the preformed obturator tip (Siegler AM and Lindeman HJ)

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