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What is a salpingectomy procedure?
Salpingectomy surgery is the surgical removal of one or both of the fallopian tubes. It can be used to treat certain women’s health conditions or to prevent others. A primary concern of individuals undergoing salpingectomy is future fertility.
The removal of both fallopian tubes makes natural conception impossible. Fortunately, other fertility options, such as in-vitro fertilization (IVF), may still be available. Some patients may be able to preserve their fallopian tubes with alternative tubal surgery.
Why would someone need a salpingectomy?
A salpingectomy or salpingostomy can be performed for several reasons, including:
- Infection due to sexually transmitted or other diseases
- Tubal adhesions
- Scarring or blockage due to previous tubal surgery
- Blocked or ruptured fallopian tube
- Sterilization (permanent contraception)
- Risk reduction for Fallopian tube cancer or ovarian cancer
Can a salpingectomy prevent cancer?
Fallopian tube cancer is a type of epithelial ovarian cancer. It’s rare but more common in women with a BRCA gene mutation. Almost half of women with BRCA1 or BRCA2 gene mutations have fallopian tube lesions.
A salpingectomy is one of the risk-reducing strategies that your obstetrics and gynecology healthcare provider might recommend, as some of the most aggressive forms of ovarian cancer are believed to originate in the fallopian tubes. A prophylactic salpingectomy can be performed on women who are at a high risk of ovarian cancer.
How can a salpingectomy help with 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 (when a fertilized egg implants outside of the uterus) or adhesions, both of which can further reduce the chances of conception.
What are the different types of salpingectomy?
There are two main types of salpingectomy. The first is a unilateral salpingectomy, also called a partial salpingectomy. This involves removing one or part of a single fallopian tube. Pregnancy is still possible because the other fallopian tube is intact and functioning. This type of surgery is commonly performed for conditions such as an ectopic pregnancy or a blockage in one fallopian tube.
The second is a bilateral salpingectomy. This procedure involves the complete removal of both fallopian tubes, making natural pregnancy impossible. It’s commonly performed for conditions such as fallopian tube cancer or as a permanent method of contraception. This surgery is often referred to as a total salpingectomy.
How can I know if fallopian tube surgery is right for me?
Fallopian tube surgery is an invasive treatment and may not be the right choice for every patient. Dr. Aliabadi will take your complete medical history and perform a physical and pelvic exam. If you are undergoing infertility treatment, she will want you and your partner to complete a full infertility evaluation.
Dr. Aliabadi may then use one of two procedures to better assess your fallopian tubes’ condition.
- Diagnostic laparoscopy
A small incision is made in your lower abdomen, and a lighted camera is inserted into your pelvis. This procedure allows Dr. Aliabadi to examine your fallopian tubes for damage or disease.
- Hysterosalpingogram
A small amount of fluid is injected into your uterine cavity through the vagina and cervix, and then an X-ray image is taken of your pelvis. The fluid is specially formulated to be visible to X-rays. If the fluid does not appear to flow completely through your Fallopian tubes, there is a good chance of a blockage.
How is salpingectomy surgery performed?
Unfortunately, too few surgeons perform salpingectomy surgery laparoscopically on an outpatient basis. I do over 99% of mine this way. For more information about our advanced salpingectomy minimally invasive outpatient surgical procedures, please visit our Outpatient Hysterectomy Center website.
Salpingectomy surgery can be performed using either open abdominal surgery (laparotomy) or laparoscopy. Each type of surgery has pros and cons. Your health history, age, and future fertility plans are considered when determining which procedure is correct for you.
The two ways salpingectomy can be performed include:
Abdominal salpingectomy
Abdominal surgery involves making a large incision in the lower abdomen, through which the surgeon can view the pelvic organs and remove the fallopian tube tissue. It 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 a large mass needs to be removed, abdominal surgery may be preferred.
Laparoscopic salpingectomy
In this less-invasive salpingectomy surgery 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.
Salpingectomy laparoscopic surgery is generally less painful and requires less recovery time. However, not all patients are good candidates for it. Occasionally, the surgeon may begin a procedure laparoscopically only to find that it would be better completed abdominally.
Recovering from salpingectomy surgery
Abdominal salpingectomy patients usually require 3 – 6 weeks of recovery time, while laparoscopic patients 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 try to get regular light exercise. This will help you maintain your strength and improve circulation after surgery.
Returning to work within a few days is highly probable, 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 immediately.
Why Trust Dr. Aliabadi with Your Reproductive Help?
Dr. Aliabadi is an expert OB/GYN, knowledgeable in all aspects of women’s health and well-being, including reproductive concerns and conditions. Dr. Aliabadi and her caring, supportive staff are available to support you through menopause, childbirth, infertility, or even just routine gynecological care.
We invite you to establish care with Dr. Aliabadi. Please make an appointment online or call us at (844) 863-6700.
Dr. Thais Aliabadi’s practice and Outpatient Hysterectomy Center are conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.
While both procedures result in permanent infertility, a salpingectomy involves the removal of the fallopian tubes for medical or preventive reasons. In contrast, tubal ligation involves blocking or sealing the tubes as a method of birth control.
As with most surgeries, there are associated risks. A laparoscopic bilateral salpingectomy may include reactions to general anesthesia, blood clots, infection, and damage to surrounding tissue and organs.
No, a salpingectomy does not cause menopause because the ovaries, which produce hormones, are left intact. However, the long-term side effect of a bilateral salpingectomy is infertility, as it cannot be reversed.
Salpingectomy is the surgical removal of a fallopian tube. In contrast, salpingostomy is the creation of an opening into the fallopian tube, often to remove an ectopic pregnancy.
A bilateral salpingectomy-oophorectomy is a surgical procedure that involves the removal of both fallopian tubes and both ovaries.
Sources:
Opportunistic Salpingectomy as a Strategy for Epithelial Ovarian Cancer Prevention
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/04/opportunistic-salpingectomy-as-a-strategy-for-epithelial-ovarian-cancer-prevention
A Pragmatic and Evidence-Based Management of Ectopic Pregnancy
https://www.sciencedirect.com/topics/medicine-and-dentistry/salpingectomy
Comparison of laparoscopy and laparotomy in the surgical management of ectopic pregnancy
https://pubmed.ncbi.nlm.nih.gov/23217480
