A vessel sealing device and an ultrasonic dissector are equally effective and safe for single port laparoscopic ovariectomy in dogs.

OBJECTIVE: To evaluate ovary removal surgery times and intraoperative complication rates between a 5-mm Sonicision cordless ultrasonic dissector (SCUD) and 5-mm vessel sealing device (VSD) for laparoscopic ovariectomy in dogs. ANIMALS: Client-owned, intact female dogs (n = 10) presented for elective laparoscopic ovariectomy. METHODS: In each dog, 1 ovarian pedicle was randomly assigned to the SCUD group and 1 to the VSD group. In the SCUD group (n = 10), the ovariectomy was performed using the SCUD device; the ovariectomy in the VSD group (10) was performed using a VSD. The number of applications of each device during ovariectomy, surgery time required for each ovary removal, total surgery duration, ovarian pedicle fat score, and intraoperative complications were recorded. RESULTS: Both left and right ovaries had median pedicle fat scores of 2 (range, 1 to 3). To complete an ovariectomy, the median number of SCUD applications was 9 (range, 7 to 13) times; the VSD had a median of 10 (range, 5 to 18) times (P = .98). Median surgery times for the removal of 1 ovary with the SCUD and VSD were 96 seconds (range, 45 to 417 seconds) and 110 seconds (range, 42 to 164 seconds), respectively (P = 1). No intraoperative complications were associated with either device. Therefore, the VSD was not required for rescue in the SCUD group, and no conversions to open ovariectomy were necessary. CLINICAL RELEVANCE: A standard approach laparoscopic ovariectomy performed with the SCUD was successful in our population of dogs, making the 5-mm SCUD safe for laparoscopic ovariectomy in healthy dogs, which provides a more affordable option for practitioners and clients.

Use of a T'LIFT transabdominal organ retraction device in two-portal laparoscopic ovariectomy in dogs.

OBJECTIVE: To describe the use of the T'LIFT transabdominal organ retraction device to suspend ovaries during canine laparoscopic ovariectomy (LapOVE) and compare its use to a transabdominal suspension suture (TSS). DESIGN: Randomized clinical trial. ANIMALS: Client-owned intact bitches (n = 30). METHODS: Dogs were randomly assigned either to group T, in which LapOVE was performed with the T'LIFT, or to group S, in which a TSS was used. Laparoscopic ovariectomy was performed by using a standard two-portal protocol. Signalment (age, weight, body condition score [BCS], fat score of the ovarian pedicle [FSOP]), overall operative time, ovarian resection time, and perioperative complications were compared between groups. RESULTS: No significant differences were found between groups regarding age, weight, BCS, or FSOP. Surgical times were not significantly different between groups. No significant differences in major or minor complications were recorded. Overall operative time was significantly shorter for the last half of the cases compared with the first half, for the overall population, and within each group. Ovarian resection time for the last cases was significantly shorter compared with that for the first ones only in group T. CONCLUSION: The T'LIFT was used to suspend ovaries for two-portal LapOVE, with no major complications noted. There was no significant difference in surgical times or complications compared with transabdominal suturing. CLINICAL SIGNIFICANCE: The T'LIFT can be considered as an alternative to transabdominal suture for ovarian suspension in dogs undergoing LapOVE.

Laparoscopic ovariectomy in guinea pigs: A pilot study.

OBJECTIVE: To assess the feasibility and safety of laparoscopic ovariectomy in guinea pigs utilizing 3-mm minilaparoscopic instruments. STUDY DESIGN: Experimental pilot study. ANIMALS: Guinea pigs (n = 3). METHODS: The guinea pigs were sedated, placed under general anesthesia, and intubated under endoscopic visualization. A 3-port technique was used with a 3.9-mm cannula for the endoscope and two 3.5-mm cannulas accommodating 3-mm endoscopic instruments including a 3-mm vessel sealing device, grasping forceps, and endoscopic scissors. The abdomen was insufflated with CO2 to a pressure of 6-8 mm Hg. The guinea pigs were manually tilted 90° laterally to visualize the dorsally positioned ovaries. RESULTS: The procedure was successfully performed in all 3 animals. The surgery times were 120, 45, 45 minutes for the 3 guinea pigs, and anesthesia times were 186, 90, and 76 minutes, respectively. Placing the animals in complete lateral recumbency was found to be critical to visualize and manipulate the ovaries. The guinea pigs recovered smoothly from anesthesia. CONCLUSION: Laparoscopic ovariectomy with 3-mm minilaparoscopic instrumentation using a 3-port technique was feasible in guinea pigs. CLINICAL SIGNIFICANCE: Laparoscopic ovariectomy can be considered as an alternative to open ovariectomy as an elective surgical technique to prevent reproductive disorders in guinea pigs.

Histological evaluation of sheep ovarian tissue after laparoscopic partial ovariectomy.

In the present study, there was assessment of the damage to tissue caused by partial laparoscopic ovariectomy using bipolar forceps in sheep. Fragments of ovaries of six sheep were removed using bipolar forceps by making a transverse section in the middle third of the organ via three-portals that were made using laparoscopy. The fragments were subjected to standard histological examinations and the lesions attributed to the procedure were investigated using an optical microscope and Image J software. The results were assessed using an analysis of variance and the Tukey test. All the laminae had minimal tissue damage. The mean amount of highly damaged tissue was 1.8%, and of partially damaged tissue was 5.6%. The mean total area of healthy tissue in the fragments was 94.4%. The results of the study indicate this procedure can be conducted withvery little tissue damage occurring. The use of this procedure, therefore, can be incorporated in future reproductive studies without altering the functions of the in situ ovarian tissues.

Ovariectomy/Orchiectomy in Rodents.

This chapter describes the surgical procedures for ovariectomy and orchiectomy in mice and rats. In addition to providing technical details of the surgical techniques, details of anesthesia options and pre-, peri-, and postoperative care are also included.

Laparoscopic-assisted ovariohysterectomy for the treatment of pyometra in a Bengal tiger (Panthera tigris tigris).

A laparoscopic-assisted ovariohysterectomy was performed in a 19-year-old intact, female Bengal tiger (Panthera tigris tigris) presented for surgical treatment of pyometra. A multi-port technique was used with intra-corporeal sealing of the ovarian pedicles and extra-corporeal ligation of the uterine vessels and body. The tiger recovered from surgery and anesthesia without complication, was released into its enclosure the same day, and has remained clinically normal. Laparoscopic-assisted ovariohysterectomy may have advantages over open ovariohysterectomy for treatment of pyometra in the tiger.

Ovario-hystérectomie assistée par laparascopie pour le traitement de pyométrite chez un tigre du Bengale(Panthera tigris tigris). Une ovario-hystérectomie assistée par laparascopie a été réalisée sur un tigre du Bengale femelle intacte âgée de 19 ans (Panthera tigris tigris) présentée pour le traitement chirurgical d'un pyomètre. Une technique multi-ports a été utilisée avec le scellement intracorporel des pédicules ovariens et la ligature extracorporelle des vaisseaux et du corps utérins. Le tigre s'est rétabli de la chirurgie et de l'anesthésie sans complication, a été remis en liberté dans son enclos le même jour et est demeuré cliniquement normal. L'ovario-hystérectomie assistée par laparoscopie peut avoir des avantages par rapport à l'ovario-hystérectomie ouverte pour le traitement du pyomètre chez le tigre.(Traduit par Isabelle Vallières).

Comparison of two vessel-sealing devices for laparoscopic-assisted ovariohysterectomy in dogs. / Vergleich zweier Instrumente zur Gefäßversiegelung bei der laparaskopisch-assistierten Ovariohysterektomie der Hündin.

OBJECTIVE: The study aimed to compare two different vessel-sealing devices (VSD) for laparoscopic-assisted ovariohysterectomy in dogs. MATERIAL AND METHODS: In this randomized, prospective clinical trial 12 consecutive, client-owned, healthy, intact female dogs of different breeds were included. The dogs had been admitted for elective laparoscopic-assisted ovariohysterectomy and were randomly assigned to one of two treatment groups. The LigaSure™ was used in one group (n = 6), and the other group was operated using the Caiman® (n = 6). Recorded variables were duration of all surgical steps, number of seals required for transection of each ovarian pedicle, number of previous uses of the VSD, and complications related to each VSD. RESULTS: Transection of the ovarian pedicles using the Caiman® required significantly fewer seals per ovary. However, overall surgical time was not significantly reduced. Intraoperative hemorrhage occurred in both groups but was more common in the LigaSure™ group. Emergency conversion to laparotomy was not required in any case. CONCLUSION AND CLINICAL RELEVANCE: The Caiman® can be safely used for laparoscopic-assisted ovariohysterectomy in dogs. In comparison with the Liga Sure™, the Caiman® requires fewer seals to transect ovarian pedicles, owing to the advantages of a longer working length and the first-tip closure mechanism.

Vessel sealer and divider instrument temperature during laparoscopic ovariectomy in horses.

OBJECTIVE: To determine the temperature of a vessel sealer and divider device during unilateral paralumbar laparoscopic ovariectomy in standing, sedated mares. STUDY DESIGN: Prospective study. ANIMALS: Fifteen healthy research mares. METHODS: Healthy mares with normal ovarian palpation and ultrasonographic appearance were enrolled. Horses were restrained in standing stocks and sedated. A right or left paralumbar ovariectomy was performed with a laparoscopic portal and 2 instrument portals. Ovaries were excised with traumatic forceps and a blunt tip vessel sealer and divider. Temperatures of the vessel sealer and divider were recorded with a thermocouple device adhered to the tip of the instrument. Variables were reported as median and interquartile range (IQR). RESULTS: Surgical time was 30 minutes (IQR, 25-32) including use of the vessel sealer and the divider for 4.1 minutes (IQR, 3.2-5.8). The tip of the instrument reached temperatures of 77°C (IQR, 72-85) during activation and 64°C (IQR, 61-67) at end cycle. The median increase in end-cycle instrument tip temperature per activation cycle was 2°C (IQR, -1-6). All mares returned to their intended use. CONCLUSION: Despite the instrument temperatures observed during unilateral laparoscopic ovariectomy, surgical complications were minimal. The clinical relevance of the increase in instrument tip temperature of the vessel sealer and divider is presently unclear, but surgeons should use the instrument with caution, especially in close proximity to viscera. The increase in temperature observed at the tip of the vessel sealer and divider during unilateral ovariectomy could be associated with morbidity. The clinical relevance of instrument tip heating during other procedures, such as adhesiolysis and intestinal resection, is unknown and should be evaluated.

LAPAROSCOPIC OVARIECTOMY IN THE ASIATIC BLACK BEAR (URSUS THIBETANUS) WITH THE USE OF THE SONICISION™ DEVICE.

Laparoscopic ovariectomy was performed in two Asiatic black bears ( Ursus thibetanus ). Bears were placed in a 20° Trendelenburg position on a surgical table. A three-portal technique was used. A camera port was established 10 cm caudal to the umbilicus with a 5-mm cannula. Two instrument ports were made 1 cm caudal to the umbilicus with a 5-mm cannula and 8 cm caudal to the camera port with a 12-mm cannula, respectively. The suspensory ligament, ovarian vasculature, and uterine horn tip were progressively dissected following coagulation with the Sonicision™ cordless ultrasonic dissection device. The resected ovary was exteriorized through the 12-mm instrument portal site but enlarged to a 2-cm incision length. The abdominal musculature, subcutaneous tissue, and skin of the portal sites were closed separately. Total surgical time was 113 min (Bear A) and 49 min (Bear B), and no postoperative complications were encountered. This is the first report of laparoscopic ovariectomy in the Asiatic black bear.

Cordless ultrasonic dissector versus advanced bipolar vessel sealing device for laparoscopic ovariectomy in dogs.

OBJECTIVE: To compare Sonicision cordless ultrasonic dissector (SCUD) to LigaSure vessel sealing device (LVSD) for laparoscopic ovariectomy (Lap OVE) in dogs. STUDY DESIGN: Randomized, paired prospective clinical trial. ANIMALS: Client-owned dogs (n = 22) presented for elective Lap OVE. METHODS: Dogs were randomly assigned to one of two protocols: protocol 1 required the left ovary resected using SCUD and the right ovary using LVSD; protocol 2 required the left ovary resected using LVSD and the right ovary using SCUD. Duration of ovary excision, complications, surgical smoke production, and collateral thermal damage were compared between SCUD and LVSD. Total surgery duration, postoperative convalescence, obesity, mesovarial fat score, and technique-associated costs were also recorded. RESULTS: Ovary excision was significantly faster with LVSD than SCUD. Surgical smoke production was significantly greater for SCUD than LVSD. Minor pedicle hemorrhage occurred 3 times with SCUD and one time with LVSD (not significantly different) and was easily corrected intraoperative. Presence of hemorrhage significantly increased ovary excision time. Technique-associated costs were lower for SCUD than LVSD. No significant differences were found in collateral thermal damage between SCUD and LVSD. Total surgery duration and convalescence time were similar to previous reports of Lap OVE in dogs at the authors' institution. CONCLUSIONS: SCUD is a cost-effective alternative for Lap OVE, taking into account differences in technique and user preference.

[LIFTING LAPAROSCOPY IN SIMULTANT SURGERY].

Results of treatment of 84 patients, to whom simultant operative interventions on abdominal, the small pelvis and retroperitoneal organs were performed for concomitant somatic diseases, were analyzed. The author's technology of laparolifting was applied in 36 patients, and classical technology with carboxyperitoneum adjustment - in 48. Variants of optimal operative accesses were determined, structure and rate of postoperative complications, peculiarities of the early postoperative period course studied. Indisputable advantages of the lifting laparoscopic operations were established, including reduction of the postoperative complications rate and severity, the postoperative pain syndrome intensity, the concurrent chronic diseases exacerbation rate, and postoperative stationary stay.

Total laparoscopic hysterectomy using a percutaneous surgical system: a pilot study towards scarless surgery.

OBJECTIVE: The evolution of minimally invasive surgery has moved beyond reduction of surgical trauma while maintaining adequate efficacy and safety standards. Percuvance™ Percutaneous Surgical System (PSS) instruments represents the last novelty in this panorama. Consisting of less than 3mm laparoscopic shaft introduced percutaneously with an interchangeable 5mm tool installed in place of the needle tip, they combine micro-invasiveness and operative performance. STUDY DESIGN: We prospectively collected and retrospectively analyzed data of 10 cases of laparoscopic total hysterectomy with Percuvance™ PSS for benign or early malignant gynecological diseases in order to assess the capability and safety of this new device. Data were recorded in a prospectively designed clinical database including patient demographics characteristics, operative data, intra- and postoperative complications, conversion rate, length of hospital stay and cosmetic outcome. RESULTS: The reported series consisted of 10 patients undergoing total laparoscopic hysterectomy with a median age of 51.5 years (range 44-72 years) and a median BMI (body mass index) of 25.3 (range 19.7-30.4). All patients had bilateral salpingo-oophorectomy or bilateral salpingectomy and two of them underwent pelvic lymphadenectomy. A median operative time of 67min (range 45-180min) and a median estimated blood loss (EBL) of 50ml (range 10-100ml) were registered. Median PSS introduction time was 5min (range 3-10min). No conversions to standard laparoscopy or laparotomy were required and no intraoperative complications occurred. Discharge was on day 1 in 4 cases, on day 2 in the other 6 cases. All patients conveyed complete satisfaction with the cosmetic result and postoperative pain control. No complications were registered within 30 days after surgery. CONCLUSIONS: PSS total laparoscopic hysterectomy is safe and feasible with good results in terms of operative time, cosmesis, postoperative pain, recovery and short hospitalization. Further studies are needed to compare PSS total hysterectomy to conventional multi-access laparoscopic and other mini-invasive approaches.

A surgical glove port technique for laparoscopic-assisted ovariohysterectomy for pyometra in the bitch.

The objective of the study was to describe the feasibility of a glove port technique for laparoscopic-assisted surgical treatment of canine pyometra. In this retrospective case series, a total of 10 female dogs (median age 7 years, range 5.5-10.5 years; median weight 37.0 kg, range 12.9-64.0 kg) with pyometra were included. A multiaccess port was created from a surgical glove attached to an Alexis wound retractor and placed in the ventral midline between the middle and caudal third of the distance between umbilicus and pubic rim. A vessel sealing device was used for transection of the ovarian pedicle. The port size was selected on the basis of maximum uterine diameter determined by ultrasound. Median incision length was 5.0 cm (range 3.1-7.7 cm) for a maximum uterine diameter of 4.0 cm (range 2.0-7.0 cm). Median surgical time was 57 minutes (range 48-65 minutes). No case had to be converted to open celiotomy. Complications included one case of minor, self-limiting splenic trauma by the endoscope. In eight dogs, the distended uterine horns endangered safe access to the ovarian pedicle, and the vessel sealing device was inserted through a second cannula placed periumbilically. Extension of the original incision was necessary to exteriorize organs in two dogs. All dogs recovered quickly and were discharged either on the day of surgery or 1 day thereafter. In conclusion, a surgical glove port technique in combination with an Alexis wound retractor is feasible for surgical laparoscopic treatment of canine pyometra up to a diameter of 7 cm.

Natural orifice transluminal endoscopic surgery in humans: feasibility and safety of transgastric closure using the OTSC system.

BACKGROUND: NOTES is a technique in which an operation is performed within the body without a skin incision by using a natural body orifice to provide access. The principal challenge of transgastric NOTES procedures is still the feasibility and safety of access closure. Currently, there are very limited data regarding the closure of transgastric NOTES in humans, and the standard method and device for closure has not been defined. Herein, we evaluate the feasibility and safety of gastric closure after NOTES procedures in humans with the over-the-scope clip (OTSC). METHODS: Review of collected data of patients underwent transgastric NOTES in prospective clinical studies between April 2010 and March 2014 focused on the gastric closure with the OTSC. RESULTS: A total of 43 patients underwent transgastric NOTES: 36 patients with an acute appendicitis, six patients with a prophylactic bilateral salpingo-oophorectomy, and one patient with uterus myomatosus. In all 43 cases, the incision of the gastric wall and the endoscopic access to the abdominal cavity succeeded without any difficulty. After performing transgastric procedures, it was possible to close the access by OTSC in all cases. There were all in all three adverse events: one major (Clavien-Dindo Grade III) and two minor (Clavien-Dindo Grades I and II). CONCLUSION: Even if we could show for the first time in more than 40 consecutive patients that there is a safe approach for closing the transgastric access, it is absolutely necessary that further investigation in clinical settings has to be done to establish clear indications and guidelines for the use of transgastric NOTES.

TELELAP ALF-X Robotic-assisted Laparoscopic Hysterectomy: Feasibility and Perioperative Outcomes.

STUDY OBJECTIVE: To show the safety, feasibility, and perioperative outcomes of total TELELAP ALF-X hysterectomy (SOFAR S.p.A., ALF-X Surgical Robotics Department, Trezzano Rosa, Milan, Italy). DESIGN: Phase II study (Canadian Task Force II-2). SETTING: Catholic University of the Sacred Heart, Rome, Italy. PATIENTS: From October 2013 to May 2014, 80 women underwent total TELELAP ALF-X hysterectomy. The study population was divided into 2 groups according to surgical procedures: total hysterectomy ± bilateral salpingo-oophorectomy (group 1) and endometrial cancer patients staged with pelvic lymphadenectomy (group 2). INTERVENTIONS: Total TELELAP ALF-X hysterectomy ± bilateral salpingo-oophorectomy with or without pelvic lymphadenectomy. MEASUREMENTS AND MAIN RESULTS: The median age was 51 years (range, 48-79), and the median body mass index was 24 kg/m(2) (range, 17.3-34.2). Forty-five patients (56.2%) had previous surgery. The median operative time was 140 minutes (range, 58-320) in group 1 and 197 minutes (range, 129-290) in group 2 (p < .001). The median docking time was 8 minutes (range, 3-25). During the study period, a significant trend in operative time reduction was observed. Procedures were successfully performed without conversion in 93.7% of cases. We observed 2 (2.5%) intraoperative complications, 3 (3.7%) conversions to standard laparoscopy, and 2 (2.5%) to laparotomy. The median time to discharge was 2 days (range, 1-5). One patient (1.2%) was readmitted in the early postoperative period. CONCLUSION: As new technology evolves, critical appraisal of patient-related outcomes, use, cost, and access to minimally invasive hysterectomy must remain a priority. Despite the relative small number of our series, we showed the feasibility and safety of total TELELAP ALF-X hysterectomy for benign and malignant disease.

Cardiorespiratory Changes and Pain Response of Lift Laparoscopy Compared to Capnoperitoneum Laparoscopy in Dogs.

OBJECTIVE: To compare intraoperative physiologic variables and post-operative pain associated with lift laparoscopy and conventional capnoperitoneum laparoscopy. STUDY DESIGN: Prospective randomized case controlled study. ANIMALS: Healthy dogs (n = 30). METHODS: Dogs having laparoscopic ovariohysterectomy were randomly assigned to lift laparoscopy (n = 14) or capnoperitoneum (16) laparoscopy. Physiologic variables measured intraoperatively were documented. Postoperatively, pain response was assessed in a blinded fashion using the short Glasgow pain scale and von Frey filament aesthesiometry. RESULTS: Lift laparoscopy was associated with less frequency of hypercapnia, required less anesthetic gas, and was not more time-consuming or painful than capnoperitoneum laparoscopy. CONCLUSIONS: Lift laparoscopy is a feasible alternative to capnoperitoneum laparoscopy, especially in dogs where pressurized capnoperitoneum is not desired.

A comparison of peritoneal fluid values in mares following bilateral laparoscopic ovariectomy using a vessel sealing and dividing device versus placement of two ligating loops.

The objective of this study was to determine the effect of bilateral laparoscopic ovariectomy on peritoneal fluid values in mares and compare how this effect was modified by the method of ovarian vessel hemostasis used. Ten mares undergoing standing bilateral laparoscopic ovariectomy were used in a randomized clinical study. During surgery, blood vessels within the mesovarium were either: (1) sealed and transected with a vessel sealing and dividing device (VSDD), or (2) ligated using two loops placed proximal to each ovary and then the mesovarium transected using laparoscopic scissors. The ovaries were removed through the ipsilateral body wall. Abdominocentesis was performed before surgery and 24 h and 72 h after surgery. Markers of peritoneal inflammation, as measured by total nucleated cell count, total protein (TP) and red blood cell count via abdominocentesis, were consistently increased for all groups compared to pre-operative values. The mean (range) of TP for the VSDD group was 4.14 (3.9-4.5) g/dL, and that for the ligating loop group was 3.18 (2.7-3.5) g/dL. Use of the VSDD resulted in significantly greater TP concentrations in the abdominal fluid at 24 h and 72 h post-operatively when compared to a ligating loop (P <0.001 and 0.04, respectively).

Use of a motorized morcellator for elective bilateral laparoscopic ovariectomy in standing equids: 30 cases (2007-2013).

OBJECTIVE: To describe the use of a motorized morcellator for elective bilateral laparoscopic ovariectomy in standing equids and to evaluate long-term outcome. DESIGN: Retrospective case series. ANIMALS: 30 equids (20 horses, 9 mules, and 1 pony). PROCEDURES: Medical records of equids undergoing elective bilateral laparoscopic ovariectomy from 2007 to 2013 were evaluated. Cases were selected on the basis of use of a motorized morcellator for ovary extraction. Data collected included age, breed, reason for surgery, surgery date, surgical approach, intraoperative complications, surgery and morcellation times, postoperative complications, and duration of hospitalization. Long-term follow-up was obtained by telephone interview with owners, and included effectiveness at resolving original reason for surgery, time to return to usual activity, incision site appearance, signs of estrus after surgery, and overall owner satisfaction. RESULTS: 30 equids underwent laparoscopic bilateral ovariectomy with the morcellator technique. Median surgery time was 102 minutes (range, 47 to 150 minutes). Median single ovary morcellation time was 3.5 minutes (range, 2 to 8 minutes). Intraoperative complications occurred in 2 of 30 cases and included iatrogenic organ damage (uterus; 1) and persistent hemorrhage (1). Nineteen of 20 mares for which long-term follow-up was available returned to their previous use at a median of 60 days after surgery (range, 21 to 180 days). CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study indicated that use of a mechanical morcellator with a 2-portal technique for bilateral laparoscopic ovariectomy in clinically normal equids eliminated the need for a larger laparotomy incision as well as a third portal. Few complications occurred, and clients were satisfied with the procedure. The morcellator technique may offer advantages over other techniques but should only be used by experienced laparoscopic surgeons following adequate training.

Embarazo ectópico ovárico / Ectopic ovarian pregnancy

La gestación ovárica es una forma de presentación poco habitual del embarazo ectópico. El diagnóstico preoperatorio es difícil; algunos se diagnostican durante la intervención pero la mayoría necesita confirmación histopatológica. El tratamiento de elección es intentar la preservación de tejido ovárico para mantener la fertilidad mediante la enucleación del saco gestacional o la resección en cuña del ovario, preferiblemente por vía laparoscópica. En algunos casos el tratamiento con metotrexato intramuscular puede ser efectivo. Presentamos 2 casos de embarazo ectópico ovárico en nuestro hospital(AU)

Ovarian pregnancy is an uncommon type of ectopic pregnancy. Preoperative diagnosis is difficult. Some cases are diagnosed during surgery and most need to be confirmed by histopathological study. The treatment of choice is conservative ovarian surgery to preserve fertility such as enucleation of the gestational sac or wedge resection of the ovary, preferably by laparoscopy. In some cases intramuscular methotrexate could be effective. We report two cases of ectopic ovarian pregnancy in our hospital(AU)