A new approach for laparoscopic ovarian transposition before pelvic irradiation.
OBJECTIVE
To evaluate and describe our special design of laparoscopic ovarian transposition to a high anterolateral position using Lee-Huang point as first entrance and landmark before pelvic irradiation in premenopausal patients with a gynecologic malignancy.


METHODS
Laparoscopic surgery was conducted to transpose bilateral ovaries in consecutive cases of premenopausal women with a gynecologic malignancy requiring pelvic irradiation in a university-based, tertiary-level training center for endoscopic surgery. Ovaries were transposed to a high anterolateral position, 3-4 cm above umbilical line.


RESULTS
Laparoscopic ovarian transpositions were performed bilaterally in consecutive fourteen cases without conversion to laparotomy. The mean operating time was 128 min (range, 83-181 min) and average blood loss was 74 mL (range, 10-150 mL). No intraoperative or immediate postoperative complication related to the laparoscopic ovarian transposition procedure was observed. The mean follow-up period was 72 months (range, 42-142 months) and only one of the seven (14.29%) patients under 39 years old became ovarian failure after receiving concurrent chemoradiation.


CONCLUSIONS
The new designed method of laparoscopic ovarian transposition is a simple and safe procedure. We recommend this process to premenopausal women who required pelvic irradiation, especially for those less than 40 years old.
Huang
Kuan-Gen
KG
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University College of Medicine, 5, Fu-Hsin Street, Kwei-Shan Tao-Yuan, 333, Taiwan.
Lee
Chyi-Long
CL
Tsai
Chien-Sheng
CS
Han
Chien-Min
CM
Hwang
Lih-Lian
LL
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D010053:Ovary / Q000528:radiation effects / Q000601:surgery*; D017697:Premenopause; D011835:Radiation Protection / Q000379:methods; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*; D014625:Vaginal Neoplasms / Q000532:radiotherapy*