Department of Obstetrics and Gynecology, AP-HP, Pitié-Salpêtrière University Hospital, Paris, France.
Department of Gynecologic and Breast Surgery and Oncology, AP-HP, Pitié-Salpêtrière University Hospital, Paris, France; Faculté de Médecine, Sorbonne Université, Paris, France.
Fertil Steril. 2019 Feb;111(2):408-410. doi: 10.1016/j.fertnstert.2018.11.022.
To describe our surgical techniques for laparoscopic ovarian tissue harvesting and orthotopic ovarian cortex grafting (LOOCG).
This video article uses surgical cases to demonstrate the detailed surgical techniques. Institutional Review Board approval was not required for this video presentation.
University hospital.
PATIENT(S): Patients presenting with indication for fertility preservation by means of ovarian tissue harvesting and orthotopic ovarian cortex grafting (in case of setting up a high risk of gonadotoxicity treatment or patients presenting with a pathology with risk of premature ovarian failure).
INTERVENTION(S): Ovarian tissue harvesting: The entire ovary is harvested by placing an EndoGIA stapler to ensure the control of infundibulopelvic ligament and then, after reloading, the section of the mesovarium. LOOCG one-step procedure: A large and superficial incision of the peritoneum is performed to create a peritoneal pocket. The fragments of ovarian cortex are secured with the use of nonresorbable surgical wire (Prolene 5.0) and introduced into the peritoneal pocket. The peritoneum is not closed after placing the graft.
MAIN OUTCOME MEASURE(S): Value and feasibility of LOOCG. Restoration of endocrine function and fertility results.
RESULT(S): Thirty-four patients were included from November 2011 to October 2017. LOOCG restored ovarian endocrine activity in 88.2% of cases. Ten patients had become pregnant (29.4%), and the same number gave birth to at least one child.
CONCLUSION(S): Our surgical approach is simple, safe, and reproducible and seems to be as effective as previously described techniques. It deserves to be proposed to patients eligible for ovarian cortex grafting.
描述腹腔镜卵巢组织采集和原位卵巢皮质移植（LOOCG）的手术技术。
本视频文章使用手术病例来演示详细的手术技术。本视频演示不需要机构审查委员会的批准。
大学医院。
因卵巢组织采集和原位卵巢皮质移植（在存在性腺毒性治疗高风险的情况下或存在卵巢早衰风险的疾病的情况下）而有生育力保存指征的患者。
卵巢组织采集：通过放置 EndoGIA 吻合器来采集整个卵巢，以确保控制输卵管卵巢韧带，然后重新加载后，切除中肾系膜。LOOCG 一步法：在腹膜上进行大而浅的切口，以创建腹膜袋。用不可吸收的手术缝线（Prolene 5.0）固定卵巢皮质碎片，并将其引入腹膜袋中。移植后不关闭腹膜。
LOOCG 的价值和可行性。内分泌功能和生育结果的恢复。
2011 年 11 月至 2017 年 10 月期间共纳入 34 例患者。LOOCG 恢复了 88.2%病例的卵巢内分泌功能。10 例患者怀孕（29.4%），同样数量的患者至少生育了一个孩子。
我们的手术方法简单、安全且可重复，似乎与以前描述的技术同样有效。它值得向有资格接受卵巢皮质移植的患者推荐。
