A salpingectomy is a surgical procedure to remove a fallopian tube. Your doctor may recommend having your fallopian tube(s) removed as a treatment for fertility problems or tubal disease, including cancer or infection.
The fallopian tubes are the two narrow tunnels extending from the uterus to the two ovaries. During menstruation, an egg is released from the ovaries and guided into the fallopian tubes by the tiny finger-like fimbriae. The egg then travels through the fallopian tube into the uterus. An egg can either be fertilized by a sperm in the fallopian tube, prompting a pregnancy, or it will be shed with the uterine lining during the woman’s next period.
Removal of both fallopian tubes makes natural conception impossible. Other fertility options, such as in-vitro fertilization (IVF), may still be available. Some patients may be able to preserve their fallopian tubes with an alternative tubal surgery.
Salpingostomy and Fimbrioplasty
Some patients may need intensive treatment for fallopian tube diseases, but may still wish to conceive naturally. As an alternative to removal of the fallopian tube, some doctors may recommend fallopian tube reconstruction.
A salpingostomy involves removing a blockage or creating a new opening – also known as a stoma – for the fallopian tube. It is often used when a patient’s tubes have been damaged by disease, a past surgery, or adhesions. Adhesions are areas of scar tissue that cause organs to stick together.
Most salpingostomies will be performed along with a fimbrioplasty, which is a reconstructive procedure to salvage the tiny, delicate fimbriae. The fringe-like fimbriae guide a ripened egg toward the opening of the fallopian tube. Preservation of the fimbriae increases fertility for women who wish to conceive naturally.
Not every patient is a good candidate for tubal reconstruction surgery. Your doctor may not recommend this type of treatment for women who have:
- Stage 3 or 4 tubal cancer
- Severe adhesions
- A history of ectopic pregnancy
- A previous salpingostomy
What Conditions can a Salpingectomy Treat?
A salpingectomy or salpingostomy can be performed to treat several serious gynecological conditions.
- Tubal cancer or tumors
- Infection due to sexually transmitted or other diseases
- Tubal adhesions
- Scarring or blockage due to previous tubal surgery
- Ectopic pregnancy
- Ruptured fallopian tube
- Infertility. Although it may seem counter-intuitive, removing one or both fallopian tubes can often lead to better fertility outcomes than repairing the tubes. For some infertile women, having a salpingectomy has been shown to increase the chances of implantation via IVF. Furthermore, defective fallopian tubes may put you at risk for ectopic pregnancy or adhesions.
How will my Doctor Determine my Candidacy for Fallopian Tube Surgery?
Fallopian tube surgery is an invasive treatment and may not be the right choice for every patient. Your doctor will take a complete medical history and perform a physical and pelvic exam. If you are undergoing treatment for infertility, your doctor will want you and your partner to complete a full infertility evaluation.
Your doctor will then use one of two procedures to get a better understanding of the condition of your fallopian tubes.
In a diagnostic laparoscopy, your doctor will make a small incision in your lower abdomen, and insert a lighted camera into your pelvis. This procedure can help your doctor see your fallopian tubes and evaluate them for damage or disease.
In this procedure, your doctor will inject a small amount fluid into your uterus through the vagina and cervix, and then take an X-ray image of your pelvis. The fluid is specially formulated to be visible to X-rays. If the fluid does not appear to completely flow through your fallopian tubes, then there is a good chance there is a blockage.
How is a Salpingectomy Performed?
Your surgeon can perform a salpingectomy using either open abdominal surgery or laparoscopy. Each type of surgery has pros and cons. Your doctor will take your personal health history, age, and future fertility plans into consideration when determining which procedure is right for you.
Abdominal surgery involves making a large incision in the lower abdomen, through which the surgeon can clearly view the pelvic organs and remove the fallopian tube tissue.
Abdominal surgery typically takes longer to heal, and carries more risk for complications, such as infection or tissue damage. However, if the damage to the fallopian tube and surrounding tissue is extensive, or if there is a large mass to be removed, abdominal surgery may be preferred.
In this less-invasive procedure, the surgeon makes 1-3 small incisions in the lower abdomen, and inserts a laparoscope into the pelvis through one of the incisions. The camera at the end of the laparoscope guides the surgeon through the procedure. The fallopian tube tissue is then removed through the small incisions.
Laparoscopic surgery is generally less painful and requires less recovery time. However, not all patients will be good candidates for laparoscopic surgery. Occasionally, the surgeon may begin a procedure laparoscopically, only to find that the procedure would be better completed abdominally.
Abdominal salpingectomy patients usually require about 3-6 weeks recovery time, while laparoscopic patients will typically heal within 2-4 weeks. Both patients should be able to walk after about three days. Get plenty of rest during your recovery, but make an effort to get regular light exercise as well. This will help you maintain your strength and improve circulation after surgery.
You may be able to return to work within a few days, especially if your surgery was performed laparoscopically. However, avoid heavy lifting and other strenuous activities for at least one week following surgery. If you have any questions or concerns, or experience any symptoms of infection, such as fever, chills, or nausea, call your doctor right away.