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. Conclusion.: 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.