EP1344\u2005Fertility-sparing surgical technique in clinically early stage epithelial ovarian carcinoma: a video surgical skills

Abstract

Introduction/Background Fertility sparing surgery is becoming an important technique in the surgical management of young women with early stage ovarian carcinoma (OC). The aim of this video is to show the surgical skills to reach a minimally invasive approach in giant cyst mass. Methodology A description of the minimally invasive fertility sparing surgical technique in a young woman diagnosed with a giant cystic mass. Results A nulliparous twenty-six years old female, was incidentally diagnosed with left ovarian mass. The vaginal ultrasound described an unilocular, hypervascular cyst of 280 x140 mm in size with a solid portion, well-delimited. The Ca 125 tumor marker raised to 42.9 U/mL, HE4 155.1 pmol/L and ROMA index 56%. The magnetic resonance (MRI) described a 23 x 12 x 30 cm cystic mass with hematic and papillary proyections. The patient underwent primary conservative left oophorectomy, intra-operatory biopsy was positive for mucinous carcinoma; the omentectomy, bilateral pelvic and para-aortic lymphadenectomy and ascites fluid cytology was complete. The final histopathological conclusion was mucinous carcinoma, grade I, expand type. The key steps of fertility sparing surgery technique consist in an incision and dissection pfannenstiel type, peritoneal dissection and abdominal cavity aperture, placement of intra-abdominal alexis to create the surgical field, plastic bag fix to the ovarian cyst with surgical glue and two stitches, a control-guide drainage of the cyst, expose the left ovary and fallopian tube out of abdominal cavity with previous cyst close by an endoloop to perform the unilateral salpingo-oophorectomy. The laparoscopic staging was performed in a second time after closing the abdominal incision. Conclusion The laparoscopic equipment and surgical skills play an important role in the fertility sparing surgical in young women with early stage OC. Disclosure Nothing to disclose