Laparoscopic Tubal Recanalization Mob: [phone], www.drpradeepgarg

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1. Laparoscopic Tubal Recanalization
Dr. Pradeep Garg
Assistant Professor
Dept. of Obst. & Gynae
All India Institute of Medical Sciences, New Delhi
Email:[email protected]

2. Laparoscopic microsurgery is a new discipline that synergizes the
potential of classical microsurgery and laparoscopy
Introduction
Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi

3. Advantages of Laparoscopic Tubal Recanalization
• All microsurgical principles are well maintained like
magnification, tissue handling, haemostasis & lavage
•Avoids laparotomy & tissue trauma associated with packing &
retractors
•Minimal tissue handling & trauma
•Adhesions are minimal
•Cosmetically far better
•Faster recovery
Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi

4. Indications of Tubal Anastomosis
•Reversal of tubal sterilization procedure
•Mid-tubal block secondary to various pathology
•Tubal occlusion secondary to ectopic pregnancy treatment
•Salpingitis isthmica nodosa
•Failed tubal cannulation for proximal tubal block
Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi

5. Contraindications
•Aged 40 years or older
•Decreased ovarian reserve or ovarian failure
•Extensive tubal damage
•Hydrosalpinx with a diameter of more than 3 cm
•Inadequate proximal or distal tubal segment for reanastomosis
•Projected tubal length of less than 3 cm after the reconstruction
procedure
•Extensive pelvic/peritubal adhesions
•Any contraindication to pregnancy or surgery
•Severe male factor infertility or male sterility
Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi

6. Instrumentation
•High resolution three-chip camera
•Good light source
•High resolution monitor
•Microsurgical hand instruments
Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi

7. Chromopertubator and injection needle
Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi

8. Suction irrigation cannula and
curve monopolar hook
Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi

9. Microneedle holder and micrograsping forceps
Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi

10. Ultramicro scissors
Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi

11. Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi
3.5 mm microtrocars with automatic valve

12. Movie
To see videos on laparoscopic gynae surgeries please logon to
www .youtube.com
and type Pradeep aiims

13. Conclusion
•Laparoscopic microsurgery offers all the benefits of traditional
microsurgery coupled with the inherent advantages of laparoscopy
Dr. Pradeep Garg, Assistant Professor, Obs. & Gynae, All India Institute of Medical Sciences, New Delhi

14. For queries mail me at
[email protected]

15. •MBBS from SNMC Agra in1995
•Post graduation in obsgynaefrom All India Institute of Medical Sciences in 1998
•Three years of senior residency in obsand gynaefrom All India Institute of Medical
Sciences in 2001
•Currently working as assistant prof. in All India Institute of Medical Sciences since 2002
•Field of interest is gynaeendoscopicsurgery and infertility
•Have many publications in national and international journals
•Running endoscopictraining centre ( GynaeEndo Training Centre AIIMS) at All India
Institute of Medical Sciences since 2004 and trained more than200 candidates from
India and abroad
•Conducted many laparoscopic workshops as operating faculty in India and abroad
BiodataDr. Pradeep Garg