Laparoscopic oophoropexy for preservation of ovarian function before pelvic node irradiation

Pelvic irradiation for the treatment of Hodgkin disease in premenopausal women invariably results in ovarian failure unless the ovaries are shielded. Oophoropexy by laparotomy has been used previously to move the ovaries away from the pelvic nodal areas. We have designed, and used in one patient, a new laparoscopic technique that can be performed as an outpatient procedure and that allows radiation therapy to begin immediately. Oophoropexy was performed laparoscopically with placement of sutures through the utero-ovarian ligaments and posterior uterus. Surgical clips were placed to help identify the position of the ovaries postoperatively.