Tubal anastomosis using a tissue adhesive.

The success of reversal of tubal ligation depends on the site of the sterilization, the tubal length after the repair of the Fallopian tube, the experience of the surgeon and the duration of surgery. It is therefore worth searching for methods to simplify the operation and to shorten the time necessary without reducing the success rate. We developed a method using a fibrin-thrombin adhesive system in combination with Swolin's one-stitch technique for tubal anastomosis. Instead of four to eight sero-muscular sutures we placed only one or two sero-muscular sutures and then the anastomosis was secured by a drop of fibrin glue. Until now 33 women have been 'refertilized' by this technique. In the case of 28 patients, a follow-up period of at least one year was possible. Thirteen intra-uterine pregnancies were achieved, three were ectopic and one woman aborted. In the cases of isthmic/isthmic anastomosis there were four intra-uterine pregnancies in six patients. We believe this result is a very important step to shortening the time of surgery with respect to the rules of microsurgical technique.