Oophoropexy for ovarian torsion: a new easier technique

Abstract

BackgroundOophoropexy for ovarian torsion is easy to be done by many tools either suturing to the lateral pelvic wall, plication of the ovarian ligament or even fixation to the back of the uterus, but it is little bit difficult to do it for pregnant women with less manipulation.ObjectiveWe propose that using trocar site closure needle can be easier and faster technique to do this. To assess the feasibility of using the trocar site closure needle to do oophoropexy in ovarian torsion and its possible applicability.PatientsSeven patients presented with ovarian torsion; four of them were pregnant at 7, 15, 19 and 20 weeks of gestation, two patients with ovarian hyperstimulation in IVF cycles and one adolescent patient with hemorrhagic cyst. They were diagnosed by clinical presentation and ultrasound with Doppler analysis, and confirmed by laparoscopy where they underwent detorsion and fixation of the ovary using the trocar site closure needle.ResultsFollow up of all the cases after one week showed improvement of the symptoms and normal Doppler flow of the target ovary then after three weeks by ultrasonography which revealed normal Doppler flow in the previously torsioned ovary. Two pregnant women underwent cesarean delivery where the operated ovary was observed during the delivery and was normal in shape and freely mobile with no adhesions.ConclusionWe propose that this technique is easier, faster and more comfortable especially in ovarian torsion in pregnant women and torsion in hyperstimulated ovaries.Electronic supplementary materialThe online version of this article (doi:10.1186/s10397-017-1001-9) contains supplementary material, which is available to authorized users.

Comparison of clinical outcomes and postoperative quality of life after surgical treatment of type II submucous myoma via laparoscopy or hysteroscopy

“…7,8 Hysteroscopic transcervical resection of myoma (TCRM) also has some limitations, such as the potential for conversion to laparotomy and incomplete intraoperative resection in patients with larger or previously myomectomised submucosal myomas. 9,10 Many studies have been performed to compare the clinical outcomes of abdominal hysterectomy and laparoscopic or hysteroscopic surgery. 11 However, no final conclusions have been reached regarding the clinical outcomes, advantages, and disadvantages of laparoscopic and hysteroscopic surgery.…”

Adnexal torsion in pregnancy after in vitro fertilization

“…Recurrent adnexal torsion can also be prevented by adnexal detorsion and shortening the utero-ovarian ligament. [ 15 , 21 ] Seven cases of ovarian torsion were reported by Hosny et al [ 22 ] ; 2/7 cases had OHSS, and 50% of the patients showed clinical symptoms and hemorrhagic cysts. Fortunately, there was no recurrence in these 2 patients, who underwent detorsion and oophoropexy.…”

Isolated fallopian tube torsion

“…6 Detorsion can be performed in early stages in normal looking adnexa, so that the blood supply is resumed, as done by Pinkert in an 18 year old female with an edematous ovary and haematosalpinx. 7,8 In adolescents, treatment can be done conservatively with aspiration of the hydrosalpinx, but if it recurs, salpingectomy is recommended to prevent detorsion.…”