Vaginal Salpingectomy Techniques in the Presence of Ovarian Conservation

Abstract

Study ObjectiveTo demonstrate vaginal salpingectomy techniques in the presence of ovarian conservation. DesignTechnical video demonstrating 2 methods of Fallopian tube removal with illustrations (Canadian Task Force classification III). SettingThe 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. InterventionTwo 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. ConclusionSalpingectomy without concomitant removal of the ovaries at vaginal hysterectomy is a feasible and beneficial procedure.