Last updated: 02/17/2009

Salpingostomy may be performed via laparotomy or laparoscopy, under general or regional anesthesia. A laparotomy is an incision made in the abdominal wall through which the fallopian tubes are visualized. If the tube has already ruptured as...

a result of an ectopic pregnancy, a salpingectomy will be performed to remove the damaged fallopian tube. If rupture has not occurred, a drug called vasopressin is injected into the fallopian tube to minimize the amount of bleeding. An incision (called a linear salpingostomy) is made through the wall of the tube in the area of the ectopic pregnancy. The products of conception are then flushed out of the tube with an instrument called a suction-irrigator. Any bleeding sites are treated by suturing or by applying pressure with forceps. The incision is not sutured but instead left to heal on its own (called closure by secondary intent). The abdominal wall is then closed.

A neosalpingostomy is similar to a linear salpingostomy but is performed to treat a tubal blockage (e.g., hydrosalpinx). An incision is made to create a new opening in the fallopian tube; the tissue is folded over and stitched into place. The new hole, or ostium, replaces the normal opening of the fallopian tube through which the egg released by an ovary each menstrual cycle is collected.

Salpingostomy may also be performed laparoscopically. With this surgery, a tube (called a laparoscope) containing a tiny lens and light source is inserted through a small incision in the navel. A camera can be attached that allows the surgeon to see the abdominal cavity on a video monitor. The salpingostomy is then performed with instruments inserted through trocars, small incisions of 0.2–0.8 in (0.5–2 cm) made through the abdominal wall.

An advantage of laparoscopic salpingostomy is that the operation is less invasive, thus recovery time is quicker and less painful as compared to a laparotomy; the average duration of recovery following laparoscopy is 2.4 weeks, compared to 4.6 weeks for laparotomy. An abdominal incision, on the other hand, allows the surgeon a better view of and easier access to the pelvic organs. Several studies have indicated a reduced rate of normal pregnancy after salpingostomy by laparoscopy versus laparotomy.