Division of Pediatric Surgery, Children's National Hospital, Washington D.C, USA; George Washington University, Washington D.C, USA; Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
J Pediatr Surg. 2021 Mar;56(3):626-628. doi: 10.1016/j.jpedsurg.2020.11.004. Epub 2020 Nov 17.
Advances in pediatric cancer therapy have improved the long-term survival for many children with cancer. The awareness of quality of life aspects, specifically fertility preservation, has become a reality for many of these families and children. Ovarian tissue cryopreservation has emerged as an available fertility option for young females with cancer. Safe and effective removal of ovarian tissue in these girls is paramount. We report a laparoscopic assisted extracorporeal ovarian harvest technique that achieves this goal.
We place a 5 mm port at the umbilicus and in the right lower quadrant. Under laparoscopic guidance we place a 12 mm port in the left suprapubic area. Utilizing the 12 mm port site a monofilament traction suture is placed through the left ovary. The traction suture is used to translocate the ovary to an extracorporeal position via the 12 mm port site. Ovarian tissue is then excised utilizing standard surgical technique with the scalpel. Hemostasis is obtained and the capsule is closed with a running absorbable suture. The ovary is placed back in its native position laparoscopically.
The use of this extracorporeal ovarian harvesting technique is a safe and effective method to optimize removal and minimize tissue injury. Utilization of this technique, may have potential benefit to the young female with cancer.
儿科癌症治疗的进步提高了许多癌症儿童的长期生存率。许多这些家庭和儿童已经意识到生活质量方面的问题,特别是生育力保存,这已经成为现实。卵巢组织冷冻保存已经成为癌症年轻女性的一种可行的生育选择。安全有效地切除这些女孩的卵巢组织至关重要。我们报告了一种腹腔镜辅助的体外卵巢采集技术,可实现这一目标。
我们在脐部和右下象限放置一个 5mm 的端口。在腹腔镜引导下,我们在左耻骨上方区域放置一个 12mm 的端口。利用 12mm 端口,将一根单丝牵引缝线穿过左卵巢。牵引缝线用于通过 12mm 端口将卵巢移位至体外位置。然后利用手术刀利用标准手术技术切除卵巢组织。止血后,用连续可吸收缝线缝合囊。然后将卵巢经腹腔镜放回其原位。
这种体外卵巢采集技术的使用是一种安全有效的方法,可以优化切除并最小化组织损伤。这种技术的使用可能对患有癌症的年轻女性有潜在的益处。