| Salpingectomy | |
|---|---|
 Schematic frontal view of female anatomy | |
| ICD-9-CM | 66.4-66.6 |
| MeSH | D058994 |
Salpingectomy is the surgical removal of one or bothfallopian tubes, typically in the context ofectopic pregnancy,cancer—typicallyovarian cancer—treatment andprevention, and as a form ofcontraception.[1][2][3][4]
Salpingectomy is sometimes preferred over itsovarian tube-sparing counterparts because it provides a greater reduction in individuals' risk of ectopic pregnancy.[5] For contraceptive purposes, the procedure is more or less an irreversible form ofsterilization and more effective thantubal ligation, which can besurgically reversed.[6]
Salpingectomy differs from and predates bothsalpingostomy andsalpingotomy. The latter two terms are often used interchangeably and refer to constructing an opening in the fallopian tube to, for example, remove an ectopic pregnancy, but the tube itself is not removed.[7] Technically, the surgical construction of a tubal opening (Latin:os, 'mouth') is asalpingostomy, and incision into the tube to terminate an ectopic pregnancy is asalpingotomy.
Salpingectomy was performed byLawson Tait in 1883 in women with a bleedingectopic pregnancy; it is now established as a routine and lifesaving procedure[clarification needed]. Other indications for a salpingectomy include infected tubes (as in ahydrosalpinx) or as part of the surgical procedure for tubal cancer.[citation needed]
A bilateral salpingectomy will lead tosterility, and was used for that purpose; however, less invasive, possibly reversible procedures have become available astubal occlusion procedures. Bilateral salpingectomies continue to be requested by somevoluntarily childfree people over tubal ligation because it reduces the risk of developing cancer; this is calledprophylactic salpingectomy.[8] It can be performed non-electively on women who are at a high risk of developing ovarian cancer, as a preventative measure.
Salpingectomy has traditionally been done via alaparotomy; more recently however,laparoscopic salpingectomies have become more common as part ofminimally invasive surgery. The tube is severed at the point where it enters theuterus and along its mesenteric edge with hemostatic control.[citation needed]
Salpingectomy is commonly done as part of a procedure called asalpingo-oophorectomy, in which one or bothovaries, as well as one or both fallopian tubes, are removed in one operation (a bilateral salpingo-oophorectomy (BSO) if both ovaries and fallopian tubes are removed). If a BSO is combined with an abdominalhysterectomy (there are different methods of hysterectomy available), the procedure is commonly called a TAH-BSO: total abdominal hysterectomy with a bilateral salpingo-oophorectomy. Sexual intercourse remains possible after salpingectomy, surgical and radiological cancer treatments, and chemotherapy. Reconstructive surgery remains an option for women who have experienced benign and malignant conditions.[9]: 1020–1348
Salpingectomies were performed in the United States in the early 20th century in accordance witheugenics legislation. FromBuck v. Bell (1927):
The Virginia statute providing for the sexual sterilization of inmates of institutions supported by the State who shall be found to be afflicted with an hereditary form of insanity or imbecility, is within the power of the State under theFourteenth Amendment.[10]
Buck v. Bell, while not expressly overturned, was implicitly overturned bySkinner v. Oklahoma (1942), in which the Court held that a person's choices whether to aid in the propagation of the human species was a cognizable fundamental right guaranteed under the 14th Amendment of the Constitution, a liberty retained by the people under the 9th Amendment of the Constitution.