Salpingostomy, Salpingo neostomy - Causes, symptoms and treatment. MF.

Salpingostomy

Salpingostomy is performed when the tube is obstructed in the ampullar department. This operation is also performed after the release of the fallopian tube from the adhesions and filling it with methylene blue. In this case, against the background of the introduced blue-tooth, the stellate structure of the scar and the place of the sealed tubal ostium are more clearly visible. The ampullar department of the uterine tube at a distance of 1.5-2 cm from the prospective place of the stoma is captured with atraumatic forceps.

The coagulation of the wall of the tube in the area of ​​the center of the stellate rumen and surface coagulation along the radial scars are made using a point coagulator.

Maintaining a tight filling of the uterine tube with methylene blue, the micro-scissors produce a gradual dissection along the radial scars and the center of the stellate rumen, without attempting to penetrate immediately into the lumen of the tube. After the maximum possible dissection of the scars in the area of ​​the adhesion of the fimbria, the branche of elastic atraumatic forceps is inserted into the lumen of the uterine tube and the opening is somewhat widened.

Further, as in the operation of fimbriolysis, atraumatic forceps with elastic branches are inserted into the tube lumen and extracted in the open state.

The edges of the fimbrial part are turned out at a distance of 1-1.5 cm and superimposed 2-3 ligatures 4,0-6,0 using the technique of intracorporeal knot tying.

If there is no possibility of suturing, the endocoagulation of the peritoneum of the fimbrial part gives good results:

At a distance of 0.5-0.7 cm from the edge of the mouth of the tube, a percussive endocoagulation of the peritoneum is produced along its perimeter. Areas of endocoagulation should be separated from each other at a distance of 0.7-1.0 cm. As a result of endocoagulation, the outer layers of the wall of the tube contract and the edges of the stoma are turned outward, which prevents them from sticking together in the postoperative period.

Salpingomestomy

This operation is performed with the restoration of the patency of the pipe in the ampullar department and the lack of technical capabilities to produce it in the same place.

The mother tube is filled with methylene blue. At the site of the alleged dissection of the wall of the tube, on the side opposite to mesosalpine, linear coagulant-induced endocoagulation is performed at a distance of 2-3 cm along the ampullar part of the fallopian tube.

The wall of the pipe next to the proposed site of the incision is captured and slightly pulled up by atraumatic forceps. Micro-scissors produce a layered opening of the lumen of the tube at a distance of 1.5-2.5 cm.

When bleeding occurs bleeding sites coagulate. The edges of the neostoma are turned out 0.5-1.0 cm from each side along the incision, two seams are applied, using the suture material 4,0-6,0 using the technique of intracorporeal knot tying.