Oophorectomy for Fertility Preservation via Reduced-Port Laparoscopic Surgery

Abstract

It is suggested that fertility preservation operations before chemotherapy or radiotherapy can be safely done using reduced-port surgery.

A review of reported surgical techniques in fertility preservation for prepubertal and adolescent females facing a fertility threatening diagnosis or treatment

“…3,19,31–33 Division of the infundibulopelvic (suspensory) and utero-ovarian ligaments was carried out by a wide range of techniques and devices including bipolar electrocautery, Endo-GIA stapler, Ligasure, Harmonic scalpel, Endoloop, as well as vascular clips. 3,19,21,31,33,34 No study addressed the superiority of one technique compared to another in regards to division of the vasculature. Feigin et al reported institutional variability due to surgeon preference for which device to use for dissection and vascular ligation, but did not address or compare outcomes according to technique.…”

“…3,11 The specimen was removed with the use of an Endocatch in all cases that reported extraction methods. 3,21,33 …”

Reduced-port surgery in gynecologic fields

“…RPS is considered useful for oophorectomy and cryopreservation prior to cancer chemotherapy. 38 For cystectomy, in which countertraction is required, a small incision is placed in the suprapubic region or in the hypogastrium, and the procedure can be conducted by drawing the cyst out of the body through this incision, 39 or the incision can be used for insertion of an inspection endoscope. The procedure is carried out without pneumoperitoneum, and RPS is considered to be of great value as a surgical method that can be conducted by elevating the M A N U S C R I P T…”

Successful Ovarian Vitrification and Back-Transplantation to Preserve Fertility in a Patient Requiring Chemotherapy for Malignant Lymphoma

“…Thus, transplant surgery was successfully Figure 1: The cortex of the remaining right ovary was removed with a laparoscopic cold knife and scissors while heparin saline was instilled to maintain blood flow, and a base, 2 cm×1 cm in size, was created on the remaining ovary. procedure than routine laparoscope-assisted surgery, and ovarian cortical tissue with primordial ovarian follicles was cryopreserved by our previously reported method [11]. Briefly, the ovarian cortex was divided into 12 pieces, each 1 cm×1 cm×1 mm, placed in a plate container, and stored in liquid nitrogen [2,[11][12][13].…”

“…For patients scheduled to undergo chemotherapy or radiotherapy, it is preferable that recovery from oophorectomy be as rapid as possible; therefore, we considered RPS to be potentially suitable for these patients, and we have reported six cases of fertility preservation achieved by RPS [11].…”