Which are the ideal donor and recipient vessels for a whole ovarian transplantation?
Stéphane Ploteau1, Jean-Michel Rogez, Jacques Donnez
1Department of Gynecology-Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire, Nantes, France. stephane.ploteau@chu-nantes.fr
Objective:
To compare deep circumflex iliac (DCI) and deep inferior epigastric (DIE) pedicles as potential recipient vessels for a whole ovarian microvascular transplantation.
Design:
Anatomical study.
Setting:
Laboratory of anatomy, university center.
Patient(S):
Ten fresh human female cadavers.
Intervention(S):
Anatomical dissections, vascular injections, histologic analysis.
Main Outcome Measure(S):
Morphological analysis of the gonadic, DCI, and DIE pedicles; diameter of the vessels at regular intervals along their entire length. Comparisons of the caliber values between receiving (DCI and DIE) and gonadic pedicles aiming to determine the optimal size match.
Result(S):
We highlight a tortuous appearance of the gonadic artery. This morphology contrasted with the venous system that included two or three straight veins, one of them being wider than the others. The gonadic vessels converge into a wider artery and vein at 5 cm from the ovary. An optimal size match existed between gonadic and DCI arteries and veins sections, in 13 of 14 gonadic pedicles.
Conclusion(S):
A safe microsurgical whole ovarian transplantation is feasible if the gonadic pedicle is harvested with a minimal length of 5 cm from the ovary. The DCI pedicle seems to have the best size match with the ovarian vessels to perform a reliable end-to-end microvascular anastomosis.
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