Laparoscopic prophylactic oophorectomy in women with inherited risk of ovarian cancer

The aim of this study was to specify the surgical procedure most adapted fo r prophylactic laparoscopic oophorectomy in patients with an inherited risk of ovarian cancer. This prospective study was based on a series of 27 pati ents who underwent prophylactic bilateral laparoscopic oophorectomy between September 1995 and January 1998. Nine patients underwent an oophorectomy ( 33%) and 18 patients an adnexectomy (67%). The laparoscopic procedure was c onverted into a laparotomy in one patient in whom an ovarian adenocarcinoma was detected during the surgical procedure. During final histologic examin ation of the ovaries, 23 patients were found to have benign atypical histol ogic alterations, one patient had an ovarian adenocarcinoma and only three patients (11%) had normal ovaries. In women with an inherited risk of ovarian cancer, during the laparoscopic procedure for prophylactic oophorectomy, the abdomino-pelvic cavity should be thoroughly explored with peritoneal cytology and systematic peritoneal b iopsies. The laparoscopic procedure could be converted into a laparotomy if an ovarian cancer is discovered.