Case report of ovarian transposition and review of literature

Objective Pelvic radiotherapy is frequently used to treat pelvic tumours in premenopausal women. As there is a high probability of premature ovarian f ailure in this situation, ovarian repositioning is often required. This can now be done laparoscopically. We aimed to develop a modified technique tha t maintained the relationship between the ovaries and the fallopian tubes f or potential future conception without the requirement for further surgery. Setting A teaching hospital. Subject An 18-year-old girl with a medulloblastoma who after craniectomy re quired craniospinal irradiation. To avoid ovarian irradiation she was refer red to our unit for ovarian transposition. Intervention At the time of laparoscopic surgery the utero-ovarian ligament s were divided and the ovaries were sutured as a unit to the psoas muscle w ithout distortion of the fallopian tube. Result After surgery, X-ray examination revealed that the lateral displacem ent of the right ovary was insufficient and consequently the procedure was repeated on this side. The patient's gonadotrophin levels remained in the p remenopausal range after surgery. Conclusion Ovarian transposition that maintains the relationship between th e ovaries and fallopian tubes can be achieved by laparoscopic surgery.