[Tuboperitoneal sterility. Indications, operative techniques and results of adhesiolysis and distal tuboplasties].

Major advances in the field of laparoscopic surgery have made it possible to perform most of the adnexal repair procedures by this route. The most common operation is adhesiolysis, i.e. the excision, usually with scissors, of peritubal and ovarian adhesions. This is a rapid, simple and non-traumatic technique. In salpingostomy, the hydrosalpinx is opened at its terminal end and the gauntlet cuff eversion of the newly created infundibulum is maintained by means of defocalized CO2 laser shots or electrocoagulation. The results of laparoscopic adhesiolysis and salpingostomy are very similar to those obtained with the conventional laparotomy and microsurgery techniques. These results, plus the advantages of laparoscopy (comfort of the patient, shorter stay in hospital, absence of scars), explain why operative laparoscopy is increasingly used in the treatment of operable adhesions and distal tubal lesions. In severe lesion, there is no alternative to in vitro fertilization.