A new, laparoscopic full-thickness slice ovarian biopsy (from antimesenteric to mesenteric margin).

Abstract

This article introduces a new laparoscopic surgical technique of full-thickness slice biopsy, from antimesenteric margin to mesenteric area, of the ovary. The uteroovarian ligament with mesenteric vasculature and the infundibulopelvic ligament with its artery and veins are transitionally obliterated with atraumatic 5-mm laparoscopic clamps. This part of the operation stabilizes and decreases the blood supply to the ovary. A desirable width of full-thickness slice in the middle part of the ovary is excised from antimesenteric to mesenteric region with 5-mm laparoscopic scissors. The full-thickness slice ovarian excision stops before the mesenteric vasculature to avoid surgical injury to that area that may compromise the ovarian blood supply or return. The presence of primordial follicles in the ovary differentiates the resistant ovary syndrome from premature ovarian failure. In hypergonadotropic hypogonadism, a classic minilaparotomy is performed to obtain enough ovarian tissue for the definitive histologic diagnosis of premature ovarian failure versus resistant ovary syndrome. Simplicity and good outcome make this laparoscopic technique suitable for many clinical predicaments when a deep lesion in the ovary must be removed.