Bilateral Salpingectomy Using Percutaneous Minilaparoscopy

Arvizo, Cynthia; Uy-Kroh, M. Jean

doi:10.1016/j.jmig.2016.11.003

Cited by 5 publications

(5 citation statements)

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“…Several studies in the past have attempted to establish the relationship between salpingectomy and residual ovarian function. Biomarkers such as FSH, AMH, AFC, ovarian size, and response to ovarian stimulation in IVF cycles were used as surrogate markers to assess ovarian reserve in these studies [3,4,8,9].…”

Section: Discussionmentioning

confidence: 99%

“…The American College of Obstetricians and Gynecologists backs opportunistic salpingectomy in high-risk groups as a primary measure of cancer prevention [2]. Laparoscopic approaches, including mini-laparoscopic modifications, are favored options for salpingectomy for their advantages of lesser tissue damage and intraoperative blood loss, quicker postoperative stay, and better cosmesis [4]. Despite the many advantages offered by the procedure, the possibility of compromising ovarian function remains an unsettled concern.…”

Section: Introductionmentioning

confidence: 99%

“…Ovarian tissue compromise could stem from damage to collaterals from ovarian vessels, direct tissue injury, or lateral dissipation of energy from energy sources [3][4][5][6]. Apart from fertility concerns, a decline in ovarian function could have detrimental effects on cardiovascular health, bone strength, and even the cognitive functions of women [2].…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Salpingectomy on Ovarian Reserve Using Two Different Electrosurgical Instruments: Ultrasonic Shears Versus Bipolar Electrocautery

Zangmo,

Suresh,

Sarkar

et al. 2024

Cureus

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BackgroundSalpingectomy is a common surgical procedure in gynecology performed for various indications. Given its proximity to the ovaries and shared vascular supply, concerns have arisen regarding compromised ovarian reserve post-salpingectomy. ObjectiveWe aim to study the effect of two different energy sources (group 1: salpingectomy using bipolar electrocautery followed by division with scissors versus group 2: salpingectomy with ultrasonic shears) on residual ovarian reserve. The effect on ovarian reserve was assessed using serum levels of folliclestimulating hormone (FSH), anti-Müllerian hormone (AMH), antral follicle count (AFC), and ovarian size pre-and postoperatively. Materials and methodsAccording to the inclusion criteria, 68 women were included in the study and randomized into the bipolar electrocautery group and the ultrasonic shear group. The final analysis included 34 women in the bipolar electrocautery group and 32 in the ultrasonic shear group. Preoperatively, the ovarian reserve of all women was assessed using FSH, AMH, AFC, and ovarian size. These parameters were then reassessed at three months postoperatively, and the percentage change was analyzed. ResultsThe mean baseline serum AMH and serum FSH values in the bipolar electrocautery group were 3.9 ± 2.9 ng/ml and 6.6 ± 2.1 IU/L, respectively, comparable with the values in the ultrasonic shear group, where serum AMH was 3.2 ± 2.9 ng/ml and serum FSH was 7.3 ± 3.9 IU/L. AFC and ovarian size were comparable between the two groups preoperatively (bipolar electrocautery group AFC was 8 ± 2.2, ovarian size on the right side was 3.3 ± 0.7 cm and on the left was 3.2 ± 0.6 cm; ultrasonic shear group AFC was 5.7 ± 2.3, ovarian size on the right side was 3.4 ± 0.8 cm and on the left was 3.2 ± 0.8 cm). After three months of postoperative analysis, AFC showed a significant fall from the preoperative value in the bipolar electrocautery group compared to the ultrasonic shear group (AFC reduced from 8 ± 2.2 to 5.5 ± 2.3 vs. 8.6 ± 0.5 to 7.9 ± 2.3; p=0.002). The other parameters showed no statistically significant change. ConclusionOur study suggests that ultrasonic shear is safer than bipolar electrocautery for preserving ovarian reserve after salpingectomy. However, further research is needed to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effect of Salpingectomy on Ovarian Reserve Using Two Different Electrosurgical Instruments: Ultrasonic Shears Versus Bipolar Electrocautery

Zangmo,

Suresh,

Sarkar

et al. 2024

Cureus

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“…30,31 Higher aesthetic satisfaction with scars after mini-laparoscopy has been pointed as a key benefit of this approach, since it is consistently found in a variety of surgical procedures for gynecology, general surgery, pediatrics, and urology. [31][32][33][34] Therefore, the mini-laparoscopic approach shows important benefits in this specific population, since we are treating young women, whose cosmetic results often have a significant impact on patient satisfaction and self-esteem. Moreover, it is also adequate for this specific procedure, since it is a relatively simple technique with no complex dissection, perfectly adapted for 3-mm trocars, providing better aesthetic results while keeping the low morbidity associated with the classical laparoscopic approaches.…”

Section: Discussionmentioning

confidence: 99%

“…[24][25][26][27][28][29] Mini-laparoscopy, with 5-mm optics and 3-mm trocars, is a recent and growing surgical option in gynecology with recent studies reporting its utility and feasibility in a variety of gynecological procedures with several validated benefits. [30][31][32][33][34] Additionally, indocyanine green (ICG) is a fluorescent dye with a well-documented safety profile that is particularly useful for fluorescence-guided surgery because its excitation peak and emission peak are in near infrared (NIR). 35,36 Its applications are evolving in many fields of medicine and surgery, including lymphography and sentinel lymph node mapping in oncologic surgery, along with angiography and tissue perfusion evaluation in gynecologic, urologic, digestive, and reconstructive surgery to evaluate the viability of tissues and to assess possible anastomoses sites or anastomotic leaks.…”

Section: Introductionmentioning

confidence: 99%

Neovagina creation in congenital vaginal agenesis: New mini-laparoscopic approach applying intraoperative indocyanine green fluorescence

Oliveira

Ferreira

2020

Surg Innov

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Background. There is still no standardized treatment for vaginal agenesis; surgical repair using a minimally invasive technique is a good option, as it offers rapid results along with a fast postoperative recovery. Objective. To describe a new modified Vecchietti procedure by a mini-laparoscopic approach with intraoperative use of indocyanine green fluorescence technology for the creation of a neovagina in the setting of congenital vaginal agenesis. Methods. Retrospective review of all cases of congenital vaginal agenesis submitted to a mini-laparoscopic modified Vecchietti procedure with intraoperative use of indocyanine green (ICG) fluorescence (between June and September 2019). Patient relevant medical history, surgical technique, postoperative care, outcomes, and complications are described. Results. Four patients with Mayer–Rokitansky–Küster–Hauser syndrome (mean age: 19 years; mean preoperative vaginal length: 1.5 cm) were included in the study. The procedure was completed successfully and uneventfully in all patients. External traction device was removed 5–7 days after surgery and replaced by external vaginal silicone dilators. This technique was able to create 10–11 cm neovaginas in 1 week; six weeks after surgery all patients had an epithelized 10.5–12 cm length and 2.5–3 cm diameter neovagina. Complications consisted of one case of isolated fever at the ninth postoperative day, solved with empiric antibiotic treatment. Conclusion. The mini-laparoscopic modified Vecchietti approach, associated with ICG fluorescence imaging, is feasible and effective in the treatment of congenital vaginal agenesis, as it is a simple and safe procedure with promising outcomes.

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