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Chapter-49 Hysteroscopic Tubal Cannulation for Proximal Tubal Block

BOOK TITLE: State of the Art Atlas of Endoscopic Surgery in Infertility and Gynecology

Author
1. Jain Nutan
2. Goel Vandana
ISBN
9788184489903
DOI
10.5005/jp/books/11190_49
Edition
2/e
Publishing Year
2010
Pages
6
Author Affiliations
1. Vardhman Infertility and Endoscopy Centre, Muzaffarnagar (UP), India, Vardhman Trauma & Laparoscopy Centre Pvt Ltd, Muzaffarnagar, UP, India, Vardhman Super Specialty Hospital, Muzaffarnagar, Uttar Pradesh, India, Vardhman Trauma and Laparoscopy, Centre Pvt Ltd, Muzaffarnagar, Uttar Pradesh, India, Vardhman Trauma and Laparoscopy, Center Pvt Ltd, Muzaffarnagar, Uttar Pradesh, India, Muzaffarnagar (UP), Vardhman Infertility and Endoscopy Centre, Muzaffarnagar, Uttar Pradesh, India, Muzaffarnagar, Vardhman Trauma and Laparoscopy Center, Muzaffarnagar, Uttar Pradesh, India, Vardhman Trauma and Laparoscopy Centre Pvt Ltd, Muzaffarnagar, Uttar Pradesh, India, Vardhman Hospital Muzzafarnagar, UP, India, Vardhman Trauma & Laparoscopy Centre Pvt. Ltd, A-36, South Civil Lines, Mahavir Chowk, Muzaffarnagar 251 001, UP, India, Vardhman Trauma and Laparoscopy Center (P) Ltd, Uttar Pradesh, India, Vardhman Trauma and Laparoscopy Center (P) Ltd, Muzaffarnagar, Uttar Pradesh, India, Vardhman Infertility and Endoscopy Centre
2. Kasturba Medical College Darya Ganj New Delhi
Chapter keywords

Abstract

Development of a minimally invasive technique for correction of proximal tubal block began with interest in transcervical tubal sterilization. Since then, a variety of instruments and techniques have been developed for cannulation of fallopian tube. Fallopian tubal cannulation can be done by hysteroscopic, fluoroscopic or ultrasonic techniques. Tubal obstruction can be due to chronic salpingitis isthmica nodosa (SIN), intratubal endometriosis, amorphous material (e.g. mucus plugs), or spasm. Most of the proximal tubal obstructions are thought to be caused by inflammatory process or endometriosis, which leads to local fibrosis, but only in 7 out of 18 cases, surgically resected segment of the occluded tube showed an organic pathology. In rest of the cases the tubes appeared normal or patent with moderate fibrosis or inflammation, but were patent. So, a surgical correction is not warranted in majority of proximal tubal blocks since there is no true block. This is the basis for tubal cannulation.

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