Description of a laparoscopic technique for treating patients with ovarian remnant syndrome

Objective: A retroperitoneal approach for laparoscopic treatment of ovarian 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 preselected and preoperative, intraoperative, and postoperative data were registered prospectively. Intervention(s): For removal of remnant ovaries we used a laparoscopic retroperitoneal approach that included complete dissection of the pelvic course of the ureter and coagulation and dissection of the infundibulopelvic ligament and of the uterine vessels. Result(s): In the first patient's case, the right ureter was injured during dissection, which was initiated too far distally between ovary and external iliac vessels. Thereafter, we changed our technique to start the dissection of the ureter at the pelvic brim. No subsequent patient had an intraoperative or postoperative complication. All patients reported fewer preoperative complaints and were free of recurrence by sonographic examination. Conclusion(s): Using a retroperitoneal approach laparoscopic resection of a remnant ovary may be a safe and effective technique. (C) 1997 by American Society for Reproductive Medicine.