title: Ovarian remnant syndrome: comparison of laparotomy, laparoscopy and robotic surgery.
abstract: OBJECTIVE
  To compare laparotomy, laparoscopy and robotic surgery in the management of ovarian remnant syndrome.
  
  
  METHODS
  Retrospective comparative study.
  
  
  METHODS
  Mayo Clinic Arizona and Mayo Clinic Rochester, USA.
  
  
  METHODS
  Women who underwent surgical treatment for ovarian remnant syndrome.
  
  
  METHODS
  The clinical records of 223 patients with histologically documented residual cortical ovarian tissue excised at Mayo Clinic by laparotomy, laparoscopy or a robotic approach, from January 1985 through February 2009, were reviewed. Data collected included the patient's age, body mass index, previous medical and surgical history, symptoms, prior management of ovarian remnant syndrome, preoperative imaging study, intraoperative details, postoperative course, complications and follow-up data.
  
  
  METHODS
  Intraoperative and postoperative outcomes.
  
  
  RESULTS
  One hundred and eighty-seven patients (83.9%) were operated by laparotomy, 19 (8.5%) by laparoscopy and 17 (7.6%) by a robotic approach. Estimated blood loss and length of stay were significantly lower in the robotic and laparoscopic groups compared with laparotomy (p < 0.01). After a mean follow-up of 21.1 ± 32.4 months, the rate of pain improvement was 93.1, 94.4 and 71.4% for the laparotomy, laparoscopy and robotic surgery group, respectively.
  
  
  CONCLUSIONS
  Robotic and laparoscopic surgery for the treatment of ovarian remnant syndrome offer advantages over laparotomy in terms of reduced blood loss, lower postoperative complications and shorter length of stay.
authors.affiliation: Gynecology Department, La Paz University Hospital, Madrid, Spain. ignaciozapardiel@hotmail.com
authors.forename: Ignacio
authors.initials: I
authors.lastname: Zapardiel
authors.forename: Vanna
authors.initials: V
authors.lastname: Zanagnolo
authors.forename: Rosanne M
authors.initials: RM
authors.lastname: Kho
authors.forename: Javier F
authors.initials: JF
authors.lastname: Magrina
authors.forename: Paul M
authors.initials: PM
authors.lastname: Magtibay
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007813:Laparotomy / Q000009:adverse effects; D007902:Length of Stay / Q000706:statistics & numerical data*; D008875:Middle Aged; D010049:Ovarian Diseases / Q000209:etiology / Q000601:surgery*; D010052:Ovariectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D012086:Reoperation; D012189:Retrospective Studies; D012371:Robotics; D013577:Syndrome; D016896:Treatment Outcome