Falloposcopy in conjunction with laparoscopy: possibilities and limitations

Falloposcopy is a transvaginal microendoscopic technique to explore thehuman Fallopian tube from the uterotubal ostium to the fimbrial end.Falloposcopy provides a unique possibility to visualize endotubal diseaseand may be used therapeutically for removal of debris and for cutting downfilmy intraluminal adhesions. To assess the clinical performance offalloposcopy as part of an infertility investigation, a total of 43 womenscheduled for laparoscopy as part of an investigation of infertility had afalloposcopy performed in conjunction with the laparoscopy. All women wereinvestigated at Danderyd Hospital, Stockholm and Akademiska Hospital,Uppsala, during 1995 and 1996. Images from the endosalpinx were obtained in26 of 43 women (60.5%). In 10 women (23.3%), it was possible to obtainimages from both tubes. No images were of sufficient quality to describethe entire tubal mucosa in detail. Falloposcopy represents a unique toolfor visualization of endotubal disease and may provide a valuableinstrument for in-vivo exploration of tubal physiology. However, certaintechnical problems limit the usefulness of this method in routine clinicalpractice. These technical problems have to be solved before falloposcopycan achieve a central position in investigation and treatment of tubaldisease.