Performable in association with the removal of the ovaries and even the uterus, salpingectomy is an operation which, depending on the circumstances, can have therapeutic, preventive or contraceptive purposes.
Salpingectomy requires specific preparation, which also includes fasting, and requires the use of general anesthesia, which involves the patient falling asleep for the entire procedure.
After salpingectomy, there is a period of hospitalization, followed by an adequate recovery program.
What are the fallopian tubes: a brief review
Predominantly muscular in nature, the fallopian tubes are the two hollow organs of the female genital system that extend to the sides of the upper portion of the uterus to join the ovaries.
Also known as salpingi or uterine tubes, the fallopian tubes have the important task of collecting the egg cell (or oocyte) produced by the ovaries and directing it to the uterus for possible fertilization.
Did you know that ...
The fertilization of the egg cell can take place even when the latter is still along the fallopian tubes: thanks to their swimming capacities, in fact, the spermatozoa are able to wedge themselves up inside the salpingi and meet the oocyte.
tubal that were insensitive to drug therapy;Why is Preventive Salpingectomy Performed?
Salpingectomy with preventive purposes is the "surgical intervention that specialists recommend, in combination with" ovariectomy, to women with an alteration in the BRCA1 or BRCA2 genes since birth; in fact, congenital mutations in these two genes are known to predispose women to developing cancers such as ovarian cancer, breast cancer and fallopian tube cancer.
Did you know that ...
Men who are born with a BRCA1 or BRCA2 mutation have a predisposition to prostate cancer.
Why is Contraceptive Salpingectomy Performed?
Salpingectomy involving both fallopian tubes definitively deprives the female genital apparatus of fundamental organs at the meeting between egg and spermatozoa; such a consequence, therefore, makes this surgery a permanent method of contraception that all women of childbearing age who do not want to have children or no longer want to have can resort to.
(eg: presence of allergies, drugs taken, general health, presence of chronic diseases, etc.);How to prepare for Salpingectomy: the instructions
The pre-operative instructions are those indications that a patient must have the foresight to follow in the days preceding a certain surgical procedure.
In preparation for a salpingectomy, the pre-operative instructions consist of:
- Quitting smoking (this clearly makes sense if the patient is a smoker). Cigarette smoking makes surgical incisions more susceptible to infection and slows the healing process.
According to experts in the field, smokers should refrain from smoking from 2 weeks to go until another 2 weeks have passed since the operation. - Temporarily stop, starting a few days before salpingectomy, any drug therapy that alters the normal blood clotting process (therefore, stop any treatments based on aspirin, warfarin, heparin, etc.).
- Present yourself, on the day of the procedure, on a complete fast for at least 8 hours. This means that if the salpingectomy is scheduled in the morning, the last meal given to the patient is the dinner the day before the operation.
Fasting is part of the pre-operative instructions of any surgical procedure which, such as salpingectomy, involves the practice of general anesthesia. - Prepare a suitcase or bag containing all those personal items (clothes, linens, items for personal hygiene, etc.) useful for appropriately facing at least one day of hospitalization. As will be seen later, salpingectomy requires the patient a hospital stay of at least 24 hours (the exact duration depends on the surgical technique used).
- Ask a relative or close friend for their support on the day of the procedure, especially with regards to returning home once the operation is complete.
Please Note
If a salpingo-oophorectomy is planned (ie a salpingectomy associated with oophorectomy) or a salpingo-oophorectomy with hysterectomy, the patient is required to take, one day after the operation, a product for intestinal cleansing; moreover, she must expect in every case a hospital stay of at least one day (this is because oophorectomy and hysterectomy make the whole procedure more invasive).
during surgery.
Generally, the type of anesthesia adopted during salpigectomy operations is general anesthesia; this anesthetic practice involves the patient falling asleep for the entire duration of the operation.
The execution of the anesthesia is the responsibility of an anesthesiologist, that is a doctor specialized in Anesthesiology and Reanimation.
Removal of the fallopian tubes: how it happens
Currently, there are two different surgical techniques to perform the removal of one or both fallopian tubes:
- The abdominal technique or laparotomy technique (in such circumstances, we speak of abdominal salpingectomy or laparotomic salpingectomy) and
- The laparoscopic technique (laparoscopic salpingectomy or laparoscopic salpingectomy).
The choice of the surgical technique used for the realization of a salpingectomy is not accidental, but depends on factors such as: the purpose of the intervention, the condition to be treated and the state of health of the patient.
The medical figure specifically trained to carry out the crucial phase of the salpingectomy is the gynecologist.
For further information: Who is the Gynecologist?
ABDOMINAL OR LAPAROTOMIC SALPINGECTOMY
During abdominal salpingectomy operations, the gynecologist removes one or both fallopian tubes through an "incision of a few centimeters in the abdominal area made by himself.
The removal of one or both fallopian tubes is followed, in order, by the repair of the abdominal muscles, the closure of the incision with sutures and the bandaging of the operated area.
Due to the non negligible size of the surgical incision, abdominal salpingectomy is not only the most invasive surgical technique (of the two possible), but also the one with the highest risk of adverse effects.
laparoscopic salpingectomy
During laparoscopic salpingectomy operations, the gynecologist accesses the organs to be removed through 3 small incisions of a scarce centimeter made at the abdominal level and through the use of surgical instruments (clearly, of the size of the aforementioned incisions), including the so-called laparoscope.
The removal of the organs is followed, as in the previous case, by the closure of the incisions by means of sutures and the bandaging of the wounds.
Salpingectomy performed with laparoscopic technique is a minimally invasive solution: in fact, it allows the removal of one or both fallopian tubes without resorting to large incisions.
The minimal invasiveness of laparoscopic salpingectomy leads to a significant reduction in hospitalization and post-operative recovery times.
Unfortunately, laparoscopic salpingectomy has a limitation: it cannot be performed on all patients for whom the removal of one or both uterine tubes is indicated.
Today, in the most advanced hospitals, doctors who practice laparoscopic salpingectomy can use a robot, which allows them to perform even more precise and less invasive interventions (robotic salpingectomy).
Duration of Salpingectomy
Including the anesthesia phase, the salpingectomy takes about one hour.
In the event that salpingectomy is associated with other interventions (oophorectomy and hysterectomy), its duration also increases by a couple of hours.
, the connection to a drip, the administration of painkillers and, only in the case of abdominal salpingectomy, the additional connection to an abdominal drainage tube (the latter serves to avoid the accumulation of blood where the gynecologist made the incision ).Sensations After Salpingectomy
After the salpingectomy and once the effects of the anesthesia wear off, the patient will feel pain in the operated area (this explains the administration of painkillers); this sensation is all the more intense after abdominal salpingectomy.
In the event that the salpingectomy has provided for general anesthesia, it is highly likely that, upon awakening, the patient complains of tiredness, confusion, lack of balance, slow reflexes and headaches; these are temporary sensations, resulting from the aforementioned practice anesthetics, which disappear within 24 hours after awakening.
Salpingectomy: when to remove the stitches
Except in special cases, the removal of the sutures applied during the salpingectomy takes place 5-7 days after the operation.
Salpingectomy: Recovery Time
The recovery times from salpingectomy are the longer, the more invasive the surgical technique adopted was.
Generally, full recovery occurs:
- After 3-6 weeks, just in case abdominal salpingectomy, And
- After 2-4 weeks, in case of laparoscopic salpingectomy.
Salpingectomy: Do's and Don'ts During Recovery?
While recovering from a salpingectomy, the patient must:
- Be at rest, but not overdo it. From the first moments following the intervention, the patient should stand up and walk, even for a few minutes; this measure serves to prevent the dangerous vascular complications connected to excessive immobility (deep vein thrombosis).
- Avoid lifting heavy objects and playing sports for 2-3 weeks. The resumption of all these activities must take place gradually.
To this, it must be added that the patient can resume her normal diet immediately and take a bath, as long as she carefully wash the operated area.
Recovery after Salpingectomy combined with other interventions
When salpingectomy is combined with oophorectomy and possibly hysterectomy, hospitalization and recovery times are lengthened, and the abstention from certain activities lasts longer.
to anesthetic, neurological damage and death);Did you know that ...
Death due to the practice of general anesthesia is a phenomenon that affects 1 individual every 100,000-200,000 people; therefore it is very rare.
Consequences of Bilateral Salpingectomy
Women who have undergone bilateral salpingectomy can no longer have children naturally, but can still experience pregnancy if they resort to in vitro fertilization.
The above also applies in the case of bilateral salpingo-oophorectomy (in this case, ad hoc hormone therapy is also required), but not after a salpingo-oophorectomy with hysterectomy.
For further information: In Vitro Fertilization: What is it?
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