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A low-cost approach to salpingectomy at cesarean delivery.
Guo, Xiaoyue Mona; Hall, Evelyn F; Mazzullo, Lisa; Djordjevic, Miroslav.
Afiliação
  • Guo XM; Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, IL. Electronic address: mona.guo@northwestern.edu.
  • Hall EF; Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
  • Mazzullo L; Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
  • Djordjevic M; Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
Am J Obstet Gynecol ; 222(5): 503.e1-503.e3, 2020 05.
Article em En | MEDLINE | ID: mdl-31981512
ABSTRACT
There is increasing adoption of opportunistic salpingectomy for ovarian cancer prevention at the time of gynecologic surgery, which includes the postpartum period. However, there is no consensus on an ideal surgical approach for the parturient vasculature. We describe a safe, low-cost, and accessible approach for bilateral salpingectomy during cesarean delivery that we call the "Mesosalpinx Isolation Salpingectomy Technique" (MIST) that can guide institutions to standardize their postpartum salpingectomy procedures when advanced vessel-sealing devices are not available. In the MIST technique, avascular windows are created within the mesosalpinx close to the tubal vessels. The vasculature is thus fully skeletonized and isolated from the adjacent mesosalpinx before suture ligation, which ensures security of the free-tie to the individual vessels and avoids sharp injury to the mesosalpinx. Not using vessel-sealing devices also eliminates the risk of thermal injury to the adjacent ovarian tissue and vasculature and potentially achieves a cost-savings for the hospital and patient. MIST has been performed in 141 cesarean deliveries in the past 4 years. There were no noted bleeding complications during the salpingectomy procedure, blood transfusions, or instances of postoperative surgical reexploration. In our experience, a surgeon who is new to the procedure takes approximately 15 minutes to complete a bilateral salpingectomy. Those surgeons who are experienced in MIST need only 5 minutes. A video is included that demonstrates the technique.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Ovarianas / Esterilização Reprodutiva / Cesárea / Salpingectomia Tipo de estudo: Health_economic_evaluation Limite: Female / Humans / Pregnancy Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Ovarianas / Esterilização Reprodutiva / Cesárea / Salpingectomia Tipo de estudo: Health_economic_evaluation Limite: Female / Humans / Pregnancy Idioma: En Ano de publicação: 2020 Tipo de documento: Article