Temporary ovarian suspension at laparoscopy for prevention of adhesions.
We performed an innovative technique of temporary ovarian suspension after operative laparoscopy for stage 3 and 4 endometriosis and evaluated the results in a retrospective study. Subjects were 20 women who underwent operative laparoscopy for infertility. Temporary ovarian suspension to the anterior abdominal wall was performed as the last step in the surgical procedure. It was done in an attempt to separate adhesiogenic surfaces during the initial phase of tissue healing (5-7 days). No complications occurred. After excluding patients who had additional infertility factors and/or were of advanced reproductive age, nine women tried to conceive spontaneously. Of these, five conceived (55%): three delivered, one pregnancy continues (80%), and one woman had an ectopic pregnancy (20%). Of the remaining 15 patients who failed to conceive spontaneously, 5 had a second-look laparoscopy. In four patients (80%), we found no evidence of recurrent adhesions. The remaining 20% had minimal adhesions. Temporary ovarian suspension appears to be simple and safe, and may be effective in preventing postoperative adhesions near the ovaries after operative laparoscopy for advanced endometriosis.
Abuzeid
Mostafa I
MI
Division of Reproductive Endocrinology, Hurley Medical Center, Two Hurley Plaza, Suite 101, Flint, MI 48503, USA.
Ashraf
Mohammad
M
Shamma
F Nicholas
FN
D000328:Adult; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D010053:Ovary; D012189:Retrospective Studies; D013537:Sutures; D000267:Tissue Adhesions / Q000517:prevention & control