Journal of minimally invasive gynecology · 2017
Vaginal Salpingectomy Techniques in the Presence of Ovarian Conservation.
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Cornella Jeffrey L
Аннотация
STUDY OBJECTIVE: To demonstrate vaginal salpingectomy techniques in the presence of ovarian conservation.
DESIGN: Technical video demonstrating 2 methods of Fallopian tube removal with illustrations (Canadian Task Force classification III).
SETTING: The prevalence of salpingectomy at the time of hysterectomy has increased significantly since 1998 [1]. One reason for the increased rate of salpingectomy is the relationship of serous ovarian carcinomas to fimbrial serous tubal intraepithelial carcinomas [2]. A Swedish population-based study reported that salpingectomy is an effective measure to reduce ovarian cancer risk in the general population [3]. Prophylactic salpingectomy and delayed oophorectomy may be an acceptable alternative in some BRCA mutation carriers [4]. A retrospective cohort study of 425 vaginal hysterectomies showed that 88% of patients were able to successfully undergo concomitant salpingectomy [5]. Mayo Clinic Institutional Review Board approval was not required for this video article.
INTERVENTION: Two methods of salpingectomy are demonstrated differing in the final disposition of the proximal Fallopian tube (segment). The 2 different methods are shown to increase clarity and understanding of the technique.
CONCLUSION: Salpingectomy without concomitant removal of the ovaries at vaginal hysterectomy is a feasible and beneficial procedure.
DESIGN: Technical video demonstrating 2 methods of Fallopian tube removal with illustrations (Canadian Task Force classification III).
SETTING: The prevalence of salpingectomy at the time of hysterectomy has increased significantly since 1998 [1]. One reason for the increased rate of salpingectomy is the relationship of serous ovarian carcinomas to fimbrial serous tubal intraepithelial carcinomas [2]. A Swedish population-based study reported that salpingectomy is an effective measure to reduce ovarian cancer risk in the general population [3]. Prophylactic salpingectomy and delayed oophorectomy may be an acceptable alternative in some BRCA mutation carriers [4]. A retrospective cohort study of 425 vaginal hysterectomies showed that 88% of patients were able to successfully undergo concomitant salpingectomy [5]. Mayo Clinic Institutional Review Board approval was not required for this video article.
INTERVENTION: Two methods of salpingectomy are demonstrated differing in the final disposition of the proximal Fallopian tube (segment). The 2 different methods are shown to increase clarity and understanding of the technique.
CONCLUSION: Salpingectomy without concomitant removal of the ovaries at vaginal hysterectomy is a feasible and beneficial procedure.