Surgery Day: Blocked Fallopian Tube Repair

In this video Dr. Wilshire discusses the repair of blocked fallopian tubes with Tubal Cannulation surgery.

​Hello. This is Dr. Wilshire of Missouri Fertility in Columbia, Missouri. Today, we're doing something called a tubal cannulation.  Our patient today was told she had blocked fallopian tubes. [She had normal-looking tubes with no history of infection or of severe endometriosis.] She had a laparoscopy a number of months ago, and they were unable to get dye out through the tubes. Today, we're going to see if that is really true. What we are doing is, we are starting out with something called a hysteroscopy.  We are looking in her uterus, and we've opened up her uterus with salt water under pressure. We've cleaned out some polyps and some other abnormalities, and now we are able to see the inside of the uterus and the opening of the fallopian tubes. This is the inside of the uterus, called the endometrial cavity, and you can see the openings of both fallopian tubes. There's the left tube, which is on our right, and the right tube, which is on our left. So, now, we are going to take this wire, which is called a urologic Glidewire® (guidewire). We borrowed this wire from the urologists; they use this to remove kidney stones.  We are going to put this wire up into this tubal opening that is called the ostium, and…look at that!  It passed through a slight obstruction, and you can see the wire going up the tube. I bet you that tube is nicely open now, so we are going to slide the wire out. Fantastic. The right tube is probably open now. And now, we will go over to the left side and perform a similar procedure. There's the opening of the tube, the ostium. We are now going to advance the wire. We've encountered a little obstruction here, so we are going to see if we can get it through, and it does…fantastic!  That wire also slides up, so I bet you the left tube is open as well. I'm going to take a picture while I'm here. So, there you have it—that's called a tubal cannulation. Both tubes are now open in this nice woman, and I suspect she will be able to have babies with very little difficulty at this point. Thank you very much.  This is Dr. Wilshire of Missouri Fertility in Columbia, Missouri.