Inherited mutations in BRCA1 and BRCA2 lead to 20-50% lifetime risk of ovarian, tubal, or peritoneal carcinoma. Clinical
recommendations for women with these genetic mutations include the prophylactic removal of ovaries and fallopian tubes
by age 40 after child-bearing. Recent findings suggest that many presumed ovarian or peritoneal carcinomas arise in
fallopian tube epithelium. Although survival rate is <90% when ovarian cancer is detected early (Stage_I), 70% of women
have advanced disease (Stage_III/IV) at presentation when survival is less than 30%. Over the years, effective early
detection of ovarian cancer has remained elusive, possibly because screening techniques have mistakenly focused on the
ovary as origin of ovarian carcinoma. Unlike ovaries, the fallopian tubes are amenable to direct visual imaging without
invasive surgery, using access through the cervix. To develop future screening protocols, we investigated using our 1.2-
mm diameter, forward-viewing, scanning fiber endoscope (SFE) to image luminal surfaces of the fallopian tube before
laparoscopic surgical removal. Three anesthetized human subjects participated in our protocol development which
eventually led to 70-80% of the length of fallopian tubes being imaged in scanning reflectance, using red (632nm), green
(532nm), and blue (442nm) laser light. A hysteroscope with saline uterine distention was used to locate the tubal ostia.
To facilitate passage of the SFE through the interstitial portion of the fallopian tube, an introducer catheter was inserted 1-
cm through each ostia. During insertion, saline was flushed to reduce friction and provide clearer viewing. This is likely
the first high-resolution intraluminal visualization of fallopian tubes.