Mr. R Gazvani, MD, FRCOG

Consultant Gynaecologist

Subspecialist in Reproductive Medicine and Surgery

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Telephone +44 (0)800 689 1317

Telephone +44 (0)7860 439346

Email info@gazvani.couk


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Tubal Surgery

Salpingectomy – Salpingostomy

Salpingectomy refers to the surgical removal of a diseased fallopian tube. The procedure was first performed in women with a bleeding tubal pregnancy (ectopic pregnancy). Other indications for a salpingectomy include fluid-filled blocked tubes (known as hydrosalpinges). Salpingectomy is done in patients undergoing a hysterectomy (removal of the uterus) plus oophorectomy (removal of the ovary).

Salpingectomy is different from salpingostomy, a procedure where an opening is made into the tube to remove its contents, but the tube itself is not removed. The margins of the tubal incision are not sutured. It is still not clear which of the two techniques has most advantages and the least disadvantages for future pregnancy. Nowadays, with the progress in the field of minimally invasive surgery, the laparoscopic approach for salpingectomies or salpingostomies has become standard practice.

When performing a salpingectomy, it is important to bear in mind the close relationship between the tube and the blood supply to the ovary to avoid any potential damages to the ovarian function.

Tubal Cannulation

This is a procedure devised for the treatment of cornual occlusion or proximal tubal occlusion in women with tubal factor infertility. A tiny wire is placed through the cervix and uterus and into the tube either under x-ray guidance or via a hysteroscope. Tubal cannulation gently helps to open the tube and may relieve an obstruction in the cornual area. Laparoscopy can be performed at the same of the hysteroscopy to ensure that the tubes are not perforated with the wire and also to inject some dye through the uterus into the tubes to verify that they are open.

Laparoscopic treatment of tubal adhesions and fimbrial phimosis

Some patients with an otherwise normal fertility evaluation can have subtle adhesions over the fallopian tubes and ovaries. These adhesions appear like cobwebs (or cling-film) over the surface of these organs and can prevent the release of the egg during ovulation, prevent the tubes from picking-up the eggs and limit the motility of the tubes. Injury to the distal end of the tubes may also result in loss of or damage to the feathery appendages of the tube (fimbria), known as fimbrial phimosis. Patients at high risk for these problems include those who have had intrauterine devices for long time, those with a history of pelvic inflammatory disease (PID), appendicitis or ruptured ovarian cyst. The adhesions and the fimbrial phimosis can be treated laparoscopically (keyhole surgery).

Reversal of sterilisation

Tubal sterilisation is a common mean of birth control. The operation to reverse this permanent form of contraception is known as reversal of sterilisation or microsurgical tubal reanastomosis. The surgery employs the use of very thin microsuture to carefully put the tubes back together and is considerably more involved than the operation performed for the sterilisation.

Reversal of tubal sterilisation can be performed by laparoscopy or through a mini-laparotomy incision. If the procedure is completed by laparoscopy patients are allowed home the same day and their recovery time is much quicker as compared to mini-laparotomy, which may require up to two days of hospital stay and may restrict daily activities for a period up to four weeks.

The success of the surgery is dependent upon several factors including the length of the fallopian tube remaining after the sterilization, the use of tying, cautery or burning the fallopian tube and the expertise of the surgeon.

What you need to know about tubal surgery

If pregnancy occurs after tubal surgery there is a high risk for ectopic pregnancy (i.e. tubal pregnancy). An early pregnancy test and ultrasound scan can help confirm the site of pregnancy. Should there be uncertainty about the location of the pregnancy close monitoring in a dedicated clinic with ultrasound facilities is recommended.

Mr Gazvani is fully trained in reproductive medicine and surgery, and is one of the few skilled surgeons able to perform every kind of tubal surgery including the reversal of sterilisation by laparoscopy as a day case procedure.

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What People Say!

Natural Killer Cells

Mr R Gazvani Consultant Gynaecologist Natural Killer Cells

Natural Killer Cells are a type of lymphocyte – an immune cell – normally circulating in blood. They make up a large part of the immune system. NK cells play a major role in the rejection of tumors and cells infected by viruses. They kill those cells by apoptosis (cell shrinkage)... 


What is Menopause?

Mr R Gazvani MD FRCOG Consultant Menopause

The menopause is the brief time when a woman’s reproductive life comes to an end. The ovaries stop producing eggs, the hormone “oestrogen” is no longer secreted and the menstrual periods end.


Recurrent IVF Failure

Mr R Gazvani Consultant Gynaecologist IVF Failure

For many couples experiencing infertility. IVF constitutes the last resort treatment, sometimes after other treatment options have also failed. In general, the underlying cause for IVF failure can be attributed to problems with the embryos, the uterine environment...


What is Endometriosis?

Mr R Gazvani MD FRCOG Consultant Endometriosis

Endometriosis is a very common condition where cells of the lining of the womb (the endometrium) are found elsewhere, usually in the pelvis and around the womb, ovaries and fallopian tubes.


What Is Infertility ?

Mr R Gazvani Consultant Gynaecologist What Is Infertility

If a couple is infertile, this means that they have been unable to conceive a child after 12 months of regular sexual intercourse without birth control. Primary infertility means they have never had a child.. Secondary infertility means that the infertile person has had one or more children in the past...


Assisted Conception

Mr R Gazvani MD FRCOG Consultant Conception

Gynaecologist Mr Gazvani specialist in infertility and assisted conception treatment and pre-implantation genetic diagnosis.

Assisted Conception falls into three main areas.