Fig. 4. Uchida technique. A. A subserosal injection of a saline-epinephrine solution is made in the region of the tubal ampulla. B. The serosa is then incised with the scissors, exposing the muscular layer of the tube. A segment of the muscular layer is elevated while the serosa is simultaneously stripped back over the proximal and distal segments. C. The proximal portion of the muscular tube is ligated and excised. The proximal ligated segment then drops back beneath the serosa. D. A purse-string suture is placed around the distal tube and tied. Additional sutures may be needed to close the defect in the mesosalpinx and adjacent broad ligament involved in the earlier dissection.