The largest group of women who would be eligible for OS undergoes non-gynecological abdominal surgery. Therefore, most opportunities for further implementation of OS to reduce the incidence of tubo-ovarian carcinoma lie within these procedures. However, little research has been conducted on OS during non-gynecological surgeries. It is expected that OS during surgical and urological procedures will add around 10 minutes to the surgery, carries a low risk of complications, and does not increase recovery time or hospital stay. This expectation is based on previous studies and experiences within (gynecological) practice. Often, no additional instruments are required. OS can be performed using a Ligasure, bipolar, or monopolar scissors.

In a case study, 19 women underwent bariatric surgery, during which sterilization was performed. Most of these women received bilateral salpingectomy. No additional instruments or incisions were required. The mean additional operative time due to OS was 8.1 minutes. In one patient, salpingectomy was not feasible due to adhesions. No complications related to OS were reported. (1)

Furthermore, OS during elective cholecystectomy was studied in a multicenter trial involving 105 patients. The procedure was successful in 98 women. In 7 women, OS was not feasible due to adhesions. Most procedures were performed by a surgeon alone without gynecologist involvement, and the median additional operative time was 13 minutes. No complications occurred as a result of the OS. (2)

Additionally, a review investigated the current knowledge on OS during non-gynecological surgeries. In conclusion, OS during non-gynecological procedures appears to be a promising method for preventing ovarian cancer, but implementing such a strategy requires education, training, and organizational adjustments.

 

References:

1. Williams B. Concurrent Bilateral Salpingectomy for Sterilization at the Time of Bariatric Surgery. Surgery for Obesity and Related Diseases. 2018;14(11):S150.

2. Tomasch G, Lemmerer M, Oswald S, Uranitsch S, Schauer C, Schütz AM, et al. Prophylactic salpingectomy for prevention of ovarian cancer at the time of elective laparoscopic cholecystectomy. Br J Surg. 2020;107(5):519-24.

3. Fisch C, Gelderblom ME, Hermens R, de Reuver PR, Nienhuijs SW, Somford DM, et al. Ovarian cancer risk reduction by salpingectomy during non-gynaecological surgery: scoping review. BJS Open. 2024;9(1).