Salpingectomy is the surgical removal of one or both fallopian tubes. These tubes provide a pathway for an egg to travel from an ovary to the uterus, where it may be fertilized.
Keep reading to learn about the purposes of a salpingectomy and what the procedure entails, as well as risks and recovery.
A doctor may recommend removing one or both fallopian tubes for the following reasons:
Removing both fallopian tubes prevents pregnancy by taking away the egg's means of reaching the uterus.
An ectopic pregnancy occurs when a fertilized egg implants somewhere other than inside the uterus.
If it implants in a fallopian tube, a surgeon may have to remove the tube to prevent it from rupturing and causing life threatening bleeding.
Prevention of ovarian cancer
If a person has a high risk of ovarian cancer, their doctor may recommend a salpingectomy to reduce it.
One medical report found that women with a high risk of developing cancer, such as those with BRCA gene mutations, were 40% less likely to develop ovarian cancer, compared with women who had a regular risk, following the removal of both fallopian tubes.
Treatment for cancer
A doctor may recommend removing certain gynecological organs, including one or both fallopian tubes, a means of treating some types of cancer.
They may also suggest salpingectomy as a treatment for other gynecological conditions, such as endometriosis or a severe infection.
A surgeon may perform a salpingectomy one of two ways. They may make an open incision in the abdomen, in a procedure called a laparotomy.
Or, they may use laparoscopy, which is a minimally invasive approach that involves inserting instruments into small incisions in the lower abdomen.
Surgeons may also perform salpingectomy alongside other procedures. For example, they may do so during cesarean sections in women who have opted for salpingectomy as a method of contraception.
The procedure can vary and involve removing additional organs. Examples of these approaches include:
This involves removing one fallopian tube. It may be the right approach for an ectopic pregnancy, an infected fallopian tube, or cancer in one tube.
This involves removing both tubes. A surgeon uses this approach when the goal of the procedure is contraception, reducing the risk of ovarian cancer, or treating certain gynecological conditions.
This approach involves removing one or both ovaries and fallopian tubes. It may help treat ovarian cancer, endometriosis, or ovarian torsion, which is the twisting of an ovary. The surgeon may also choose this approach to ectopic pregnancy.
Total abdominal hysterectomy with a bilateral salpingo-oophorectomy (TAH-BSO) is surgery to remove the fallopian tubes, ovaries, uterus, and cervix.
A doctor may recommend this for people with extremely heavy periods, severe bleeding, endometriosis, uterine fibroids, cancer, or a combination.
It is important to thoroughly discuss the risks and benefits of any approach with the doctor or surgeon.
The doctor or surgeon should explain the general procedure and the specific approach. They should also describe:
- risks, benefits, and alternatives to the procedure
- the expected duration of the surgery
- how long the person can expect to stay in the hospital
- how long the whole recovery is likely to take
If the person decides to go ahead with the procedure, a doctor will likely provide them with presurgical instructions, which may involve:
- not eating or drinking after midnight before the surgery
- taking or not taking certain medications before the surgery
- temporarily refraining from taking blood thinners, with special instructions from the doctor who prescribed them
- not using perfumes, lotions, or powders the day before the surgery
- washing with a special soap or wipes to reduce the risk of infection
In other situations, including ectopic pregnancy, a surgeon may perform a salpingectomy as an emergency procedure.
Usually, a person receives a general anesthetic and is asleep and unaware of the procedure.
First, a member of the medical team will take the person to a surgical site and administer anesthetic.
A surgeon will usually attempt to perform the procedure using a minimally invasive approach. If they cannot access the fallopian tubes in this way, they may switch to an open surgical approach.
The following are the typical steps in a minimally invasive salpingectomy:
- The surgeon makes small incisions in the belly button and at least two other areas of the abdomen.
- They insert instruments, such as a thin camera on a tube, called a laparoscope, and a suction instrument, into these incisions.
- The surgeon fills the abdomen with carbon dioxide to allow for better visualization of the pelvic organs.
- They use the laparoscope to visualize the pelvic organs and assess the health of both fallopian tubes, even if they are only removing one.
- The surgeon uses the instruments to remove the fallopian tube or tubes and minimize bleeding.
- They then release the carbon dioxide, check for bleeding, and remove any excess blood or fluid.
- The surgeon removes the instruments and seals the incisions with stitches or bonding materials.
The duration of the procedure varies, depending on the person's anatomy and the approach the surgeon uses.
After surgery, anesthesia and nursing professionals will take the patient to a post-anesthesia care unit or recovery room. There, the team will monitor vital signs and pain levels to check for any immediate complications and to keep the patient comfortable.
Depending on the procedure and the person's response, they may leave the hospital the same day. When the surgery is extensive, as with a TAH-BSO, the person may need to stay overnight for close monitoring.
The person will receive a prescription for pain relief medication and instructions on caring for the surgical incision and when to resume activities, such as showering.
Anyone who experiences anything concerning during recovery should contact their healthcare team.
Recovery from a minimally invasive procedure is usually shorter than recovery from an open procedure.
As with any surgery, a salpingectomy can cause complications.
The extent of the risks depends on the approach. For example, a TAH-BSO is a significantly more invasive, and time consuming, procedure than a partial salpingectomy.
In general, risks of a salpingectomy include:
- injury to nearby organs
- adverse reactions to anesthesia
In addition, whether a doctor removes one or both fallopian tubes, it can impede blood flow to one or both ovaries.
As a result, the ovaries may not be able to adequately transmit the hormones that they produce, and this can lead to early onset menopause.
A surgeon cannot reverse a salpingectomy. Once the surgeon has removed the tube or tubes, they cannot be reconnected.
This makes the procedure different from a tubal ligation, which involves cutting or tying the fallopian tubes.
A salpingectomy has several uses, and a surgeon may use various approaches.
It is important to thoroughly discuss the reasons, risks, and options with a doctor or surgeon prior to the procedure.
The duration of recovery depends on the surgical approach and the person's general health.