Progress in tubal surgery.

There is now established proof of the value of microscopic compared with conventional techniques in tubal surgery, to enable not only accurate anastomosis but also accurate dissection of adhesions to restore normal mobility and relations between tubes and ovaries. Microscopy has also highlighted the important need for adjunctive techniques such as wide exposure, careful handling of organs and peritoneum, low-power diathermy, the use of nonreactive suture material and proper peritoneal closure. All these techniques can and should always be used, not only in tubal reconstructive surgery but in all female pelvic surgery to protect the woman's future fertility. Use of the surgical microscope and details of the various tubal operations, including those for ectopic pregnancy and reversal of sterilization, have been described, together with an outline of research into future developments.