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Ovariopexy-Before and after Endometriosis Surgery
Juhi Dhanawat1, Julian Pape1, Damaris Freytag1
1Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Building 24, 24105 Kiel, Germany.
Biomedicines
|December 1, 2020
Summary
Ovariopexy, a temporary transposition of ovaries, aids challenging endometriosis surgery by improving retroperitoneal access and reducing adhesions. This cost-effective technique has a low complication rate, though more research is needed on fertility outcomes.
Area of Science:
- Gynecologic surgery
- Minimally invasive gynecologic surgery
- Reproductive medicine
Background:
- Endometriosis surgery presents significant challenges, particularly achieving complete resection due to adhesions and anatomical complexities.
- Accessing the retroperitoneum is crucial for thorough endometriosis excision but is often hindered by pelvic adhesions and the lateral positioning of ovaries.
- High prevalence of primary and post-surgical adhesions complicates endometriosis management and can negatively impact patient outcomes.
Purpose of the Study:
- To review and describe the technique of ovariopexy (temporary ovarian transposition) as an adjunct in surgical management of endometriosis.
- To highlight the benefits of ovariopexy in facilitating retroperitoneal access and mitigating postoperative adhesions.
- To evaluate the current evidence regarding the efficacy, safety, and cost-effectiveness of ovariopexy in endometriosis surgery.
Main Methods:
- Review of existing literature on ovariopexy in the context of endometriosis surgery.
- Description of a specific surgical technique for ovariopexy, supplemented by a video demonstration.
- Assessment of ovariopexy's impact on surgical accessibility and prevention of postoperative adhesions.
Main Results:
- Ovariopexy provides improved surgical access to the retroperitoneum, crucial for complete endometriosis resection.
- The procedure is associated with a reduction in postoperative adhesions, a common complication in endometriosis surgery.
- Evidence suggests ovariopexy is cost-effective, simple to perform, and carries a very low complication rate.
Conclusions:
- Ovariopexy is a valuable and underutilized technique for enhancing surgical outcomes in endometriosis.
- While current evidence is limited, ovariopexy shows promise in preventing postoperative adhesions and aiding surgical access.
- Further robust clinical trials are warranted to definitively establish the impact of ovariopexy on fertility and adhesion prevention.
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