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Single-Incision Laparoscopic Surgery for Ovarian Tissue Cryopreservation
Gilad Karavani1, Natali Schachter-Safrai1, Henry H Chill1
1Department of Obstetrics and Gynecology, Hadassah Hebrew University Hospital, Jerusalem, Israel.
Study Objective:
To present single-incision laparoscopic surgery (SILS) as an alternative to standard multiport laparoscopic surgery (MPLS) for ovarian tissue cryopreservation.
Design:
Retrospective cohort study (Canadian Task Force classification II-2).
Setting:
Tertiary medical center.
Patients:
Two hundred thirty-one patients referred for oncologic fertility preservation.
Intervention:
Non-inferiority comparison of SILS with MPLS for ovarian cryopreservation for future transplantation.
Measurements And Main Results:
We compared duration of the procedure, intra- and postoperative complications, hospital stay, and time (days) from surgery to chemotherapy. We additionally compared number of ampules (each ampule contains 10 slivers of ovarian cortex tissue) preserved and number of oocytes retrieved during the preparation process. Adjustments for age, previous chemotherapy, and partial versus complete oophorectomy ratio were performed. MPLS was performed in 163 patients (71.2%) and SILS in 66 patients (28.8%). Ten patients (15.2%) in the SILS group and 32 (19.8%) in the MPLS group were prepubertal. Malignant conditions distribution was similar. Procedure duration and overall complication rates were similar. Number of ampules extracted from the preserved tissue was somewhat higher in the SILS group as compared with the MPLS group (14.7 vs 10.6, respectively; p < .01).
Conclusion:
Our findings suggest that SILS is an interesting alternative to MPLS. Future prospective trials may prove some benefit in ovarian tissue volume or time until chemotherapy initiation.