ORIGINAL RESEARCH article
Front. Surg.
Sec. Obstetrics and Gynecological Surgery
This article is part of the Research TopicFrom Gynecologic Treatment to Birth Outcomes: Obstetric Sequelae After Benign and Malignant InterventionsView all 6 articles
Laparoscopic vs. Laparotomy Tubal Recanalization for Fertility Restoration After Tubal Sterilization: A Retrospective Analysis
Provisionally accepted
- Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
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Objective To compare the therapeutic effects of laparoscopic recanalization and laparotomy recanalization on tubal patency restoration after tubal sterilization. Methods A retrospective analysis was conducted on the clinical data of 122 patients who underwent tubal recanalization after sterilization in one tertiary grade A hospitals in southern China from May 2013 to May 2023. The patients were divided into the laparoscopic group (n=61) and the laparotomy group (n=61) based on the surgical approach. The recanalization status, clinical indicators, and postoperative pregnancy outcomes were observed and compared between the two groups. Results The laparoscopic group had a higher recanalization rate, shorter postoperative ambulation, first flatus recovery, and hospital stay times, lower 12-hour pain scores, and less intraoperative blood loss (all P < 0.05). It also showed a higher intrauterine pregnancy rate and lower missed abortion and infertility rates (P < 0.05), with no significant difference in ectopic pregnancy rates (P > 0.05). Overall pregnancy rate was 66.39%, significantly associated with age (80.0% for ≤35 vs. 50.8% for >35 years, P=0.001) and post-anastomosis tubal length (0% for <5 cm, 58.62% for 5–8 cm, 100% for >8 cm, P < 0.001). Univariate and multivariate regression identified age at recanalization and reconstructed tubal length as independent predictors (P < 0.05); other factors showed no significant associations (P > 0.05). The ROC curve for tubal length had an AUC of 0.8808(95%CI: 0.8227-0.9389), indicating reliable predictive value. Conclusion Laparoscopic recanalization for patients after tubal sterilization is associated with less intraoperative blood loss, faster postoperative recovery, and higher recanalization and intrauterine pregnancy rates compared with open abdominal recanalization. Age and reconstructed tubal length are critical predictors of pregnancy success, highlighting their importance in preoperative assessment and surgical planning.
Keywords: Laparoscopy, Laparotomy, minimally invasive surgery, Pregnancy Outcome, Tubal recanalization
Received: 23 Dec 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Zhang, Lin, Chen, Liu and Xiong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiumei Xiong
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