Temporary ovarian suspension

Abstract

Background Following the division of adhesions, ovarian cystectomys, and/or the excision or coagulation of endometriosis, pelvic pain may continue because of re-formation of adhesions between the posterior surface of the ovary and the ovarian fossa. Various methods of adhesion prevention, such as the use of Interceed, Intergel or heparinized saline etc., have proved unsuccessful. Temporary ovarian suspension is a simple technique of suspending the ovary, for 5–7days, by attachment to the anterior abdominal wall. This allows separation of the raw area on the ovary and the ovarian fossa until surface epithelialization has occurred. When the suture is removed, the ovary falls back to its anatomical position. Objective To describe and discuss this simple technique of suspending the ovaries. Intervention The anterior abdominal wall is transilluminated with the laporoscope to demonstrate any major blood vessels, especially the inferior epigastric vessels. The junction of the lateral one-quarter and the medial three-quarters, approximately 1 inch above the inguinal ligament is the site on the anterior abdominal wall used for ovarian suspension. Non-absorbable number 0 Prolene on a straight needle is used for suturing. The needle is pushed into the abdominal cavity at the abovementioned site; it picks up the ovary and comes out of the abdominal wall at the same site. The thread is tied on the anterior abdominal wall, with appropriate adjustment of the tension. The stitch is covered with a transparent dressing which is left in position until the day of removal of the stitch.