{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:15:30Z","timestamp":1780467330711,"version":"3.54.1"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Female tubal factor infertility is a major clinical challenge. While surgical repair of the fallopian tubes remains the traditional standard, biological fibrin sealants have been proposed to reduce tissue trauma and improve reproductive outcomes. Methods: We conducted database searches of PubMed\/MEDLINE, EMBASE and Google Scholar until 31 August 2025, using the keywords \u201ctubal anastomosis\u201d, \u201ctubal reanastomosis,\u201d \u201ctubal reanastomosis\u201d, \u201cuterine horn anastomosis\u201d, \u201cfibrin glue\u201d, \u201cfibrin sealant\u201d, \u201cbiological sealant\u201d, \u201ctissue adhesive\u201d, \u201crabbit\u201d, \u201crat\u201d and \u201csterilization reversal.\u201d Reference lists of retrieved articles have been examined to find studies which tested end-to-end tubal (or small-animal uterine horn) anastomosis through biological adhesives with or without additional components to evaluate patency success, fertility results and adhesion formation. Results: Thirteen studies met the inclusion criteria (eleven animal; two human). Rat and rabbit models demonstrated that fibrin sealants with intraluminal splints and one-to-two anchoring sutures produced results comparable to microsutures for patency (tubal patency rates of 75\u2013100%) and pregnancy success (pregnancy rates of 60\u201383%) while reducing surgical time and decreasing peritubal adhesions. The success rates of the procedures depended on the anastomosis locations. Isthmic\u2013isthmic anastomosis produced better results than ampullary repairs which tended to fail or develop stenosis. Fibrin sealant-only repairs without splinting were associated with lower patency (almost 60%) despite acceptable histologic healing. Human data showed similar pregnancy rates (intrauterine pregnancy in about 40\u201350% of women) and tubal patency but no consistent decrease in adhesions. Ectopic pregnancy rates ranged from 9 to 11%. Conclusions: Fibrin sealants are useful adjuncts to microsurgical tubal repair, but they should not replace the basic repair procedures. The effectiveness of this procedure is dependent on three critical factors: precise segment alignment, proper use of splints and stents, and selection of segments with comparable caliber. In a personalized-medicine framework, fibrin-assisted reanastomosis may offer a tailored option for selected women who desire natural pregnancy. Modern standardized research is required to define indications and analyze how the adaptation of fibrin sealants in minimally invasive procedures affect reproductive outcomes, ectopic pregnancy rates, and adhesion development.<\/jats:p>","DOI":"10.3390\/jpm16010012","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T17:24:58Z","timestamp":1767201898000},"page":"12","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Effect of Fibrin Sealants on Tubal Reanastomosis: A Comprehensive Review of the Literature"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0160-7755","authenticated-orcid":false,"given":"Dimitrios","family":"Papageorgiou","sequence":"first","affiliation":[{"name":"Department of Gynecology, Athens Naval and Veterans Hospital, 11521 Athens, Greece"},{"name":"Laboratory of Experimental Surgery and Surgical Research \u201cN.S. Christeas\u201d, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4510-1633","authenticated-orcid":false,"given":"Vasilios","family":"Pergialiotis","sequence":"additional","affiliation":[{"name":"Unit of Gynecologic Oncology, First Department of Obstetrics and Gynecology, \u201cAlexandra\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7760-0608","authenticated-orcid":false,"given":"Ioakeim","family":"Sapantzoglou","sequence":"additional","affiliation":[{"name":"Unit of Gynecologic Oncology, First Department of Obstetrics and Gynecology, \u201cAlexandra\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1461-8000","authenticated-orcid":false,"given":"Eleni Sivylla","family":"Bikouvaraki","sequence":"additional","affiliation":[{"name":"Unit of Gynecologic Oncology, First Department of Obstetrics and Gynecology, \u201cAlexandra\u201d Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Salakos","sequence":"additional","affiliation":[{"name":"School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stylianos","family":"Kykalos","sequence":"additional","affiliation":[{"name":"Second Department of Propaedeutic Surgery, \u201cLaikon\u201d General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Kontzoglou","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Surgery and Surgical Research \u201cN.S. Christeas\u201d, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece"},{"name":"Second Department of Propaedeutic Surgery, \u201cLaikon\u201d General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"ref_1","first-page":"375","article-title":"Conventional Laparoscopy Is the Better Option for Tubal Sterilization Reversal: A Closer Look at Tubal Reanastomosis","volume":"2","author":"Madison","year":"2021","journal-title":"Womens Health Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.ejogrb.2023.10.017","article-title":"Microsurgical Anastomosis of the Fallopian Tubes after Tubal Ligation: A Systematic Review and Meta-Analysis","volume":"291","author":"Sastre","year":"2023","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4103\/gmit.gmit_43_23","article-title":"Where Microsurgical Tubal Reanastomosis Stands in the In Vitro Fertilization Era","volume":"13","author":"Moon","year":"2024","journal-title":"Gynecol. Minim. Invasive Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"102605","DOI":"10.1016\/j.jogoh.2023.102605","article-title":"Robot-Assisted Tubo-Tubal Reanastomosis after Sterilization in 10 Steps","volume":"52","author":"Netter","year":"2023","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1016\/j.bjps.2022.01.007","article-title":"A Systematic Review and Meta-Analysis on the Use of Fibrin Glue in Peripheral Nerve Repair: Can We Just Glue It?","volume":"75","author":"Koopman","year":"2022","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Bayer, I.S. (2022). Advances in Fibrin-Based Materials in Wound Repair: A Review. Molecules, 27.","DOI":"10.3390\/molecules27144504"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"znad361","DOI":"10.1093\/bjs\/znad361","article-title":"Topical Haemostatic Agents in Surgery","volume":"111","author":"Brown","year":"2024","journal-title":"Br. J. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1186\/s13643-024-02634-w","article-title":"The Effectiveness of Fibrin Sealants in Head and Neck Surgery: A Systematic Review and Meta-Analysis","volume":"13","author":"Nguyen","year":"2024","journal-title":"Syst. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/S0015-0282(16)46583-0","article-title":"Experimental anastomosis of the rabbit fallopian tube using fibrin glue","volume":"38","author":"Scheidel","year":"1982","journal-title":"Fertil. Steril."},{"key":"ref_10","first-page":"961","article-title":"Fibrin glue vs. nylon in the anastomosis of rabbit fallopian tube","volume":"31","author":"Dargenio","year":"1986","journal-title":"J. Reprod. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/0020-7292(84)90086-9","article-title":"Morphology of rabbit oviduct after reanastomosis with fibrin glue","volume":"22","author":"Spernol","year":"1984","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/0028-2243(88)90012-3","article-title":"Scanning electron microscopy of rabbit tubes at different intervals after anastomosis using fibrin glue","volume":"27","author":"Dargenio","year":"1988","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1093\/oxfordjournals.humrep.a136703","article-title":"Morphology and fertility after re-anastomosis of the rabbit fallopian tube with fibrin glue","volume":"3","author":"Gauwerky","year":"1988","journal-title":"Hum. Reprod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1093\/oxfordjournals.humrep.a137119","article-title":"An experimental model for pelviscopic tubal anastomoses","volume":"5","author":"Gauwerky","year":"1990","journal-title":"Hum. Reprod."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1093\/oxfordjournals.humrep.a137841","article-title":"Fibrin glue for reanastomosis of the fallopian tube in the rabbit: Adhesions and fertility","volume":"7","author":"Gauwerky","year":"1992","journal-title":"Hum. Reprod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1093\/oxfordjournals.humrep.a137991","article-title":"Fibrin glue for anastomosis of the fallopian tube\u2014Morphology","volume":"8","author":"Gauwerky","year":"1993","journal-title":"Hum. Reprod."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1093\/oxfordjournals.humrep.a136673","article-title":"Tubal anastomosis using a tissue adhesive","volume":"3","author":"Baumann","year":"1988","journal-title":"Hum. Reprod."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/S0015-0282(16)54432-X","article-title":"Effects of fibrin sealant on tubal anastomosis and adhesion formation","volume":"56","author":"Tulandi","year":"1991","journal-title":"Fertil. Steril."},{"key":"ref_19","first-page":"368","article-title":"Comparative effects of different methods of anastomosis on rat uterine horn","volume":"37","author":"Adamyan","year":"1992","journal-title":"Int. J. Fertil."},{"key":"ref_20","first-page":"229","article-title":"Reproductive function after reconstructive surgery on rat uterine horns","volume":"39","author":"Adamyan","year":"1994","journal-title":"Int. J. Fertil. Menopausal Stud."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1089\/gyn.1997.13.125","article-title":"Comparison of microsurgery and fibrin sealant in reanastomosis of the uterine horns of rats","volume":"13","author":"Kamaci","year":"1997","journal-title":"J. Gynecol. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1177\/0300060517709815","article-title":"Pregnancy outcome of laparoscopic tubal reanastomosis: Retrospective results from a single clinical centre","volume":"45","author":"Karayalcin","year":"2017","journal-title":"J. Int. Med. Res."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Godin, P.A., Syrios, K., Rege, G., Demir, S., Charitidou, E., and Wery, O. (2019). Laparoscopic Reversal of Tubal Sterilization: A Retrospective Study Over 135 Cases. Front. Surg., 5.","DOI":"10.3389\/fsurg.2018.00079"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Feng, Y., Zhao, H., Xu, H., Ai, Y., Su, L., Zou, L., Yang, L., Yang, D., Yan, X., and Ma, N. (2019). Analysis of pregnancy outcome after anastomosis of oviduct and its influencing factors. BMC Pregnancy Childbirth, 19.","DOI":"10.1186\/s12884-019-2469-2"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.fertnstert.2020.01.041","article-title":"Restoring fertility in women aged 40 years and older after tubal ligation: Tubal anastomosis versus in vitro fertilization","volume":"113","author":"Peregrine","year":"2020","journal-title":"Fertil. Steril."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/j.1447-0756.1997.tb00876.x","article-title":"Effects of fibrin glue on postsurgical adhesions after uterine or ovarian surgery in rabbits","volume":"23","author":"Takeuchi","year":"1997","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta20940","article-title":"The use of fibrin sealant during non-emergency surgery: A systematic review of evidence of benefits and harms","volume":"20","author":"Edwards","year":"2016","journal-title":"Health Technol. Assess."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1007\/s00404-024-07584-1","article-title":"Prevention of peritoneal adhesions after gynecological surgery: A systematic review","volume":"310","author":"Schaefer","year":"2024","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_29","first-page":"221","article-title":"Peritoneal Adhesions and Their Prevention\u2014Current Trends","volume":"38","author":"Neis","year":"2021","journal-title":"Surg. Technol. Int."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ghobrial, S., Ott, J., and Parry, J.P. (2023). An Overview of Postoperative Intraabdominal Adhesions and Their Role on Female Infertility: A Narrative Review. J. Clin. Med., 12.","DOI":"10.3390\/jcm12062263"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Hassanabad, A.F., Zarzycki, A.N., Jeon, K., Dundas, J.A., Vasanthan, V., Deniset, J.F., and Fedak, P.W.M. (2021). Prevention of Post-Operative Adhesions: A Comprehensive Review of Present and Emerging Strategies. Biomolecules, 11.","DOI":"10.3390\/biom11071027"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Practice Committee of the American Society for Reproductive Medicine (2021). Role of Tubal Surgery in the Era of Assisted Reproductive Technology: A Committee Opinion. Fertil. Steril., 115, 1143\u20131150.","DOI":"10.1016\/j.fertnstert.2021.01.051"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Karadag, C., and Karadag, B. (2025). Comparison of reproductive outcomes after laparoscopic tubal anastomosis using conventional (non-barbed) sutures and barbed sutures. BMC Surg., 25.","DOI":"10.1186\/s12893-025-03043-z"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jmig.2013.01.018","article-title":"Computer-assisted laparoscopy in fertility preservation and reproductive surgery","volume":"20","author":"Lipskind","year":"2013","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/S0015-0282(16)59546-6","article-title":"A Rat Uterine Horn Model of Genital Tract Wound Healing","volume":"48","author":"Schlaff","year":"1987","journal-title":"Fertil. Steril."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"291","DOI":"10.52054\/FVVO.15.4.108","article-title":"Perspectives in adhesion prevention in gynaecological surgery","volume":"15","author":"Catena","year":"2023","journal-title":"Facts Views Vis. Obgyn"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Zheng, X., Wang, F., Su, Y.C., Xu, C.Y., and Wang, M.Z. (2024). Efficacy and safety of fibrin sealant application in patients undergoing thyroidectomy: A systematic review and meta-analysis. BMC Surg., 24.","DOI":"10.1186\/s12893-024-02414-2"},{"key":"ref_38","unstructured":"Nikolaou, C., Gkioni, M., Kranidioti, E., Karampinas, P., Papatheodorou, A., and Antonopoulos, C. (2024). Could Fibrin Sealants (TISSEEL\u2122) Be Effective in the Management of Post-Hemorrhagic Complications and Anastomotic Failures? A Narrative Review. J. Clin. Med., 13."},{"key":"ref_39","first-page":"e2024.00044","article-title":"Robot-Assisted Laparoscopic Application of Fibrin Sealant Patch for Repair of Inferior Vena Cava","volume":"11","author":"Seckin","year":"2024","journal-title":"CRSLS MIS Case Rep. SLS"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/1\/12\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T17:35:40Z","timestamp":1767202540000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/1\/12"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jpm16010012"],"URL":"https:\/\/doi.org\/10.3390\/jpm16010012","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]}}}