TEMPORARY OVARIAN SUSPENSION FOR ENDOMETRIOSIS

Compassion

​left ovary is suspended to fascia of the anterior abdominal wall using
non-absorbable 3-O plain catgut

Dedication

Knowledge

Dr. Abuzeid's procedure of "Temporary Ovarian Suspension" (an innovative procedure to temporary suspend the ovary(ies) to the abdominal wall was accepted January 2018 in a video manuscript by the Journal of Minimally Invasive Gynecology (a peer-reviewed journal). 
 
This retrospective study compares the safety and efficacy of temporary ovarian suspension (TOS) to the anterior abdominal wall using absorbable versus non-absorbable suture after operative laparoscopy to elevate the ovaries away from the ovarian fossa during postoperative peritoneal repair to reduce postoperative adhesion development. Patients (# 152) underwent TOS to the anterior abdominal wall at the conclusion of operative laparoscopy between 1998 and 2016. One hundred forty-two patients underwent operative laparoscopy for advanced stages of endometriosis (93.4%); the remaining 10 patients for other indications (6.6%). In 78 patients the ovaries were suspended to the fascia using absorbable 3-0 plain catgut sutures (Group 1). In 74 earlier patients non-absorbable 3-0 mono-filamentous nylon was used to suspend the ovaries to the anterior abdominal (Group 2). In both groups there was no reported incidence of any major intra-operative complications such as bleeding, or late complications such as infection, hematoma or bowel herniation through the suture loop and its sequalae (bowel obstruction or strangulation). In all patients in both groups the ovaries were present in its anatomical location on transvaginal ultrasound scan, one week after surgery following absorption or removal of the TOS suture. There was no significant difference in overall clinical pregnancy (59.7% vs 54.8%) and delivery (51.6% vs 46.6%) rates between Group 1 and Group 2 respectively. TOS to the anterior abdominal wall, using absorbable or non-absorbable sutures, in an attempt to reduce postoperative adhesion development between the ovary and ovarian fossa, is simple, safe, easy to learn, and has potential effectiveness.