DESCRIPTION OF A LAPAROSCOPIC TECHNIQUE FOR TREATING PATIENTS WITH OVARIAN REMNANT SYNDROME

Objective: A retroperitoneal approach for laparoscopic treatment of ov arian remnant syndrome was developed. Design: Clinical study. Setting: Department of Gynecology, Friedrich-Schiller-University Jena. Patient (s): During a 29-month period, seven consecutive patients with ovarian remnant syndrome were treated by laparoscopy. Patients were not prese lected and preoperative, intraoperative, and postoperative data were r egistered prospectively. Intervention(s): For removal of remnant ovari es we used a laparoscopic retroperitoneal approach that included compl ete dissection of the pelvic course of the ureter and coagulation and dissection of the infundibulopelvic ligament and of the uterine vessel s. Result(s): In the first patient's case, the right ureter was injure d during dissection, which was initiated too far distally between ovar y and external iliac vessels. Thereafter, we changed our technique to start the dissection of the ureter at the pelvic brim. No subsequent p atient had an intraoperative or postoperative complication. All patien ts reported fewer preoperative complaints and were free of recurrence by sonographic examination. Conclusion(s): Using a retroperitoneal app roach laparoscopic resection of a remnant ovary may be a safe and effe ctive technique. (C) 1997 by American Society for Reproductive Medicin e.