Neosalpingostomy
The first step was the injection of methylene blue-saline solution via
the hysteroscope. By laparoscopy, a cross-cut was made, using cold
scissors, at the thinnest part of the blind-ending fallopian tube, and
gently extended up to 1.5 cm in order to form 4 fimbrial flaps. The
mucosa was evertedly sutured to the serosal layer with a 4-0 braided
absorbable suture and diluted methylene blue was injected in order to
access the tubal patency. During the surgical procedure, we tried to be
as gentle as possible and continuously flushed wounds with saline in
order to reduce unnecessary damage to fallopian tubes (Figure S2-B).
In addition to salpingectomy and neosalpingostomy, co-interventions were
allowed including adhesiolysis, cystectomy of ovarian cyst or Mullerian
duct cysts, myomectomy, coagulation of endometriosis and resection of
endometrial polyps.
A video of the procedure was recorded and stored. Per-operative findings
were registered instantly after the surgery, including the presence of
Fitz-Hugh-Curtis Syndrome (FHCS),18 leiomyoma, benign
ovarian cyst (including mature cystic teratomas, epithelial (serous or
mucinous) cystadenoma, Mullerian duct cyst, endometriosis (staged by
revised-AFS classification of endometriosis),19adenomyoma, and endometrial polyps. All intra- or postoperative
complications were registered.