Jong-Duk Kim

A report on 387 cases of microsurgical tubal reversals

OBJECTIVE To survey what factors influence the pregnancy outcome in an effort to improve the pregnancy rate (PR) after microsurgical reversal of tubal sterilization. DESIGN Retrospective clinical study. PATIENT(S) Three hundred eighty-seven patients who had microsurgical tubal reversal between March 1982 and January 1994. INTERVENTION(S) Postoperative pregnancy outcomes were determined by telephone, letters, and direct interviews. RESULT(S) Pregnancy outcomes were identified in 94.1% of the total patients. The overall PR was 91.6%, of which 3.9% spontaneously aborted and 1.7% were ectopic. The probability that pregnancy occurred within the first 12 months was 0.80. The median interval from the tubal reversal to pregnancy was 5.34 months. The pregnancy success rate after reversal of Falope ring sterilization was statistically significantly higher than in the other groups. Patients with reversed tubal length > or = 7 cm had a statistically significantly higher PR than those with < 7 cm. CONCLUSION(S) The overall probability of pregnancy was 0.89. The tubal length reconstructed after tubal reversal and the type of sterilization performed previously were the important factors affecting the PR.

Hemostatic ligature for operative laparoscopy

Background We introduce a safe and convenient method for ligature of vascular pedicles at laparoscopic surgery in which one laparoscopic and two auxillary ports are used. Technique The first two-turn wrap around the loop is made extracorporeally with the hand and is locked by an intracorporeal tie with manipulation of the target tissue. Knot tying is finished with the second and third nontension tie of one-turn throws. Experience We have used this method for laparoscopic surgery for more than 2.5 years and have not observed a failure or late hemorrhage. Conclusion Two-turn throw incomplete loop ligature is a useful and convenient technique for hemostasis in three-port pelviscopic operations