Culdotomy as a surgical method for tubal sterilization and tubal ectopic pregnancy treatment

Objective: To evaluate the efficacy and safety of culdotomy in surgical tubal sterilization and extrauterine tubal pregnancy, ruptured or intact.
Methods: This is a prospective study of 11 cases of extrauterine tubal pregnancy and 29 cases of tubal sterilization subjected to transvaginal adnexal surgery via culdotomy from 2009-2014.
Results: We reviewed 29 cases of culdotomic tubal sterilization as well as 11 cases of extrauterine tubal pregnancy of which 5 were intact and 6 were ruptured with hemoperitoneum. Culdotomic transvaginal tubal surgery was performed in all cases. There were no intraoperative or postoperative complications. Two units of blood were transfused in 2 cases of ruptured tubal pregnancy. Cases were selected via history and physical exam; transvaginal ultrasound excluded cases with peritoneal adhesions which make culdotomy impossible.
Conclusion: Culdotomy is a safe surgical method to enter the cul-de-sac (pouch of Douglas) and to perform tubectomy for sterilization as well as for tubal ectopic pregnancy, either ruptured or intact.