A new approach for laparoscopic ovarian transposition before pelvic irradiation

ObjectiveTo 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.MethodsLaparoscopic 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.ResultsLaparoscopic 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.ConclusionThe 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.