Salpingectomy

Definition

Salpingectomy is the removal of one or both of a woman's fallopian tubes, the tubes through which an egg travels from the ovary to the uterus.

Purpose

A salpingectomy may be performed for several different reasons. Removal of one tube (unilateral salpingectomy) is usually performed if the tube has become infected (a condition known as salpingitis).

Salpingectomy is also used to treat an ectopic pregnancy, a condition in which a fertilized egg has implanted in the tube instead of inside the uterus. In most cases, the tube is removed only after drug treatments designed to save the structure have failed. (Women with one remaining fallopian tube are still able to get pregnant and carry a pregnancy to term.) The other alternative to salpingectomy is surgery to remove the fetus from the fallopian tube, followed by surgery to repair the tube.

A bilateral salpingectomy (removal of both the tubes) is usually done if the ovaries and uterus are also going to be removed. If the fallopian tubes and the ovaries are both removed at the same time, this is called a salpingo-oophorectomy. A salpingo-oophorectomy is necessary when treating ovarian and endometrial cancer because the fallopian tubes and ovaries are the most common sites to which cancer may spread.

Description

Regional or general anesthesia may be used. Often a laparoscope (a hollow tube with a light on one end) is used in this type of operation, which means that the incision can be much smaller and the recovery time much shorter.

In this procedure, the surgeon makes a small incision just beneath the navel. The surgeon inserts a short hollow tube into the abdomen and, if necessary, pumps in carbon dioxide gas in order to move intestines out of the way and better view the organs. After a wider double tube is inserted on one side for the laparoscope, another small incision is made on the other side through which other instruments can be inserted. After the operation is completed, the tubes and instruments are withdrawn. The tiny incisions are sutured and there is very little scarring.

In the case of a pelvic infection, the surgeon makes a horizontal (bikini) incision 4-6 in (10-15 cm) long in the abdomen right above the pubic hairline. This allows the doctor to remove the scar tissue. (Alternatively, a surgeon may use a vertical incision from the pubic bone toward the navel, although this is less common.)

Preparation

The patient is given an injection an hour before surgery to encourage drowsiness.

Aftercare

Aftercare varies depending on whether the tube was removed by laparoscopy or through an abdominal incision. Even when major surgery is performed, most women are out of bed and walking around within three days. Within a month or two, a woman can slowly return to normal activities such as driving, exercising, and working.

Risks

All surgery, especially under general anesthesia, carries certain risks, such as the risk of scarring, hemorrhaging, infection, and reactions to the anesthesia. Pelvic surgery can also cause internal scarring which can lead to discomfort years afterward.

BOOKS

Carlson, Karen J., Stephanie A. Eisenstat, and Terra Ziporyn. The Harvard Guide to Women's Health. Cambridge, MA: Harvard University Press, 1996.

The Surgery Book: An Illustrated Guide to 73 of the Most Common Operations. Ed. Robert M. Younson, et al. New York: St. Martin's Press, 1993.

ORGANIZATIONS

National Women's Health Resource Center. 120 Albany St., Suite 820, New Brunswick, NJ 08901. (877) 986-9472. <http://www.healthywomen.org>.

Carol A. Turkington

KEY TERMS

Ectopic pregnancy—The development of a fetus at a site other than the inside of the uterus; most commonly, the egg implants itself in the fallopian tube.

Laparoscope—A surgical instrument with a light attached that is inserted through the abdominal wall to allow the surgeon to see the organs in the abdomen.