Surgery Day Symposium - Management of Tubal Disease in the Modern Era
Date:October 22,
2012
Time:4:15 pm - 6:15 pm
Location:Room 5 - San Diego Convention Center
Presenters
Jeffrey Goldberg, M.D. (Chair), Cleveland Clinic
G. David Adamson, M.D., Fertility Physicians of Northern California
Grace M. Janik, M.D., Reproductive Specialty Center
Steven F. Palter, M.D., Gold Coast IVF
Management of Tubal Disease in the Modern Era
Needs Assessment and Description
As in vitro fertilization (IVF) evolves into the default treatment
for all infertility, tubal surgery is becoming a lost art. Many
cases of tubal infertility can be successfully treated with
minimally invasive outpatient surgery. This live course for
physicians and clinicians involved in the care of women
with infertility will review tubal surgical procedures as an
alternative or adjunct to IVF.
Learning Objectives
At the conclusion of this session, participants should be able
to:
- Review the indications, techniques and surgical outcomes
for proximal and distal tubal disease.
- Discuss the advantages and disadvantages of IVF versus
tubal anastomosis.
- Describe the management of hydrosalpinges in women
undergoing IVF.
ACGME Competency
Patient Care
TEST QUESTION:
After participating in this session, in my practice I will:
- Recommend that a 40-year-old woman who has a prior
tubal ligation should proceed directly to IVF due to the
poor prognosis after tubal anastomosis in this age group.
- Treat proximal tubal block with hysteroscopic
cannulation, fluoroscopic cannulation or microsurgical
resection with anastomosis since these yield similar
pregnancy rates.
- Tell patients that pregnancy rates after salpingostomy
for mild hydrosalpinges are 25-30%.
- Recommend robotic-assisted laparoscopic tubal
anastomosis since pregnancy rates are better than with
mini-laparotomy.
- Tell patients that salpingectomy for hydrosalpinges
restores subsequent IVF pregnancy rates back to those
without hydrosalpinges.
- Not applicable to my area of practice.