In 1999, Dr. Tommaso Falcone and his Cleveland Clinic team published the first report on robot-assisted tubal anastomosis. Using the Zeus robotic surgical system (Computer Motion Inc.), a far less sophisticated tool than the currently available da Vinci surgical system (Intuitive Surgical), the procedure lasted more than 5 hours.
Only a decade later, Dr. Martin Caillet presented a study on robot-assisted laparoscopic microsurgical tubal reanastomosis at the First European Symposium in Robotic Gynecological Surgery in Milan, Italy (Fertil. Steril. 2010;94:1844-7). In 97 patients who underwent robot-assisted microsurgical tubal reanastomosis, using the da Vinci surgical system, the overall pregnancy and birth rates were 71% and 62%, respectively. Not surprisingly, pregnancy and delivery rates were age related. In patients less than 35 years of age, 91% became pregnant and 88% delivered. By the time a patient reached 36-39 years of age, pregnancy and delivery rates were 75% and 66%, respectively, while patients aged 40-42 years had a 50% pregnancy rate and 43.8% delivery rate. Importantly, the success rate is similar to rates reported in the most successful studies using the open microsurgical tubal reanastomosis technique.
Dr. Gargiulo will discuss his technique in this Gynecologic Surgery Master Class.