Salpingectomy

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Salpingectomy

The most frequent indication for salpingectomy is ectopic pregnancy, but the operation is also performed in isolated cases of inflammatory disease with a unilateral hydrosalpinx.

The purpose of the operation is to remove the Fallopian tube while leaving the uterus and ovary intact.

Physiologic Changes. The Fallopian tube is removed.

Points of Caution. The cornual portion of the Fallopian tube and mesosalpinx are extremely vascular areas. Hemostasis must be insured.

Technique

A laparotomy is performed through a tranverse or midline incision. The diseased tube is identified and freed of all peritubal adhesions. The cornual portion of the tube is clamped with a Kelly clamp, and the remainder is grasped with a Babcock clamp and elevated into a convenient position. Repeated fenestrations in the mesosalpinx are performed with a straight Halsted clamp. These should be clamped between small hemostats, and the tube can be excised from the cornual portion across the mesosalpinx to the fimbria.

Each of the pedicles in the hemostats should be tied with interrupted 3-0 synthetic absorbable suture. The peritoneal lining is reestablished, and the cornual portion of the tube is buried with an interrupted 3-0 mattress suture in the broad ligament into the posterior segment of the uterine cornu.

The mesosalpinx is reperitonealized with a running 3-0 synthetic absorbable suture.

The mesosalpinx has been closed with a running 3-0 synthetic absorbable suture. The procedure has been completed. The abdomen is closed in routine fashion.