What is Salpingectomy?
Salpingectomy is the surgical removal of one or both fallopian tubes, performed either as a risk-reducing procedure to prevent ovarian cancer or as treatment for conditions like ectopic pregnancy. 1
Types of Salpingectomy
Bilateral Salpingectomy
- Removes both fallopian tubes while preserving the ovaries, distinguishing it from bilateral salpingo-oophorectomy (BSO), which removes both tubes and ovaries. 1
- Can be performed as an "opportunistic" procedure during other abdominal surgeries (such as hysterectomy, cesarean section, gallbladder surgery, or hernia repair) specifically to reduce future cancer risk. 2
Unilateral Salpingectomy
- Removes a single fallopian tube, typically performed for ectopic pregnancy management or other unilateral tubal pathology. 3
Primary Clinical Applications
Cancer Risk Reduction
- Bilateral salpingectomy reduces ovarian cancer risk in the general population by eliminating the fallopian tubes, which are the site of origin for many high-grade serous ovarian cancers through serous tubal intraepithelial carcinomas (STICs). 1, 4
- For hereditary cancer syndromes (Lynch syndrome), salpingectomy is an option for premenopausal patients not yet ready for oophorectomy, serving as a temporizing measure. 2
- In BRCA1/2 carriers, salpingectomy alone is NOT recommended as standard of care because it does not provide the 80-90% risk reduction achieved by bilateral salpingo-oophorectomy and lacks proven mortality benefit. 1, 4
Sterilization
- Bilateral salpingectomy is increasingly preferred over traditional tubal ligation for permanent contraception because it provides superior contraceptive efficacy, eliminates risk of ectopic pregnancy, and reduces ovarian cancer risk. 5, 6
Ectopic Pregnancy Treatment
- Salpingectomy removes the entire affected fallopian tube when managing tubal ectopic pregnancy, as an alternative to salpingotomy (which preserves the tube by removing only the pregnancy tissue). 3
- Women generally prefer salpingectomy over salpingotomy when avoiding repeat ectopic pregnancy is prioritized over maximizing spontaneous intrauterine pregnancy rates. 7
Critical Distinctions from Related Procedures
Salpingectomy differs fundamentally from salpingo-oophorectomy: the former preserves ovarian function and hormone production, while the latter causes immediate surgical menopause if performed bilaterally in premenopausal women. 2, 8
Important Caveats
- Salpingectomy does not eliminate ovarian cancer risk entirely—a residual risk of primary peritoneal carcinoma remains even after complete tubal removal. 4
- For high-risk populations (BRCA carriers), salpingectomy without oophorectomy sacrifices the breast cancer risk reduction (approximately 45-50%) that premenopausal oophorectomy provides. 4
- Salpingectomy for sterilization eliminates the possibility of natural conception, requiring in vitro fertilization if pregnancy is desired later. 5