Chapter 76: PEARS for the Fallopian Tubes: Distal Occlusions and Other Applications

This chapter describes PEARS surgery on the distal fallopian tube, covering distal tubal anomalies, large peritubal cysts, elongation of the fimbria ovarica, endometriosis of the distal tube and distal tubal occlusion. In 81 consecutive patients with histologically proven endometriosis, peritubal cysts, accessory fallopian tubes and fimbrial bands were found significantly more often than in a group of 30 women examined at cesarean section, while accessory tubal ostia did not differ significantly. Because these anomalies are mullerian in origin, the chapter states that the finding lends some support to the theory that endometriosis is at least in part hereditary. Microsurgical techniques are illustrated for removing peritubal cysts, accessory tubes and distal tubal endometriosis and for cuff fimbrioplasty of occluded tubes, and the chapter concludes that damaged tubes can be surgically reconstructed and made patent.