{"paper_id":"0719befc-8c95-4ed4-94ef-14fc69074e38","body_text":"Copyright © 2025 Jeju National University Institute for Medical Science\nArticles published in JMLS are Open Access, distributed under the terms of the Creative Commons Attribution-Noncommercial License (https://creativecommons.org/\nlicenses/by-nc/4.0/).\neISSN: 2671-4922\nJournal of Medicine and Life Science Vol. 22, No. 1, 28-29, January 2025\nhttps://doi.org/10.22730/jmls.2025.22.1.28\nLaparoscopic management of endometrioma following ovarian \ntransposition during radical hysterectomy\nChul Min Park\nDepartment of Obstetrics & Gynecology, Jeju National University College of Medicine, Jeju, Republic of Korea\nKey words:Ovary; Transposition; Endometriosis Received : August 12, 2024\nRevised  : October 24, 2024\nAccepted : October 28, 2024\nCorrespondence to \nChul Min Park\nDepartment of Obstetrics & Gynecology, \nJeju National University College of \nMedicine, 15 Aran 13-gil, Jeju 63241, \nRepublic of Korea\nTel: 82-64-754-8169\nFax: 82-64-717-1131\nE-mail: obgymd@jejunu.ac.kr\nLetterJournal of Medicine and Life Science\nOvarian transposition is typically performed during rad -\nical hysterectomy in young premenopausal patients with \ncervical cancer to prevent ovarian damage caused by adju -\nvant radiotherapy.\n1-3\n Some patients may experience pain at \nthe site of ovarian transposition because of functional cysts \nor benign tumors. A prospective study reported that two \npatients who underwent ovarian transposition developed \nbenign ovarian cysts that subsequently required oophorec -\ntomy.\n4\n However, predisposing factors for the development \nof ovarian tumors at previous ovarian transposition sites \nremain unknown. I encountered a case in which an endome-\ntrioma developed at the site of ovarian transposition during \na radical hysterectomy. Therefore, I would like to share my \nexperience with laparoscopic surgery for managing endo -\nmetriomas that develop after ovarian transposition.\nIn January 2023, I performed laparoscopic radical hys -\nterectomy and transposition of both ovaries in a 41-year-old \npatient with stage IB1 cervical cancer. After 6 months, the \npatient complained of pain on the right side of the ovarian \ntransposition site. In August 2023, abdominopelvic comput-\ned tomography (APCT) revealed a 5.3 cm cystic lesion ante-\nrior to the cecum, possibly associated with ovarian transpo-\nsition. In September 2023, the patient visited the emergency \nroom with the sudden development of right abdominal pain \nand was admitted for further evaluation and pain control. \nAPCT showed the newly developed fluid collection in the \npelvic cavity and around the cystic lesion anterior to the \ncecum, raising concerns about the hemoperitoneum asso -\nciated with the rupture of a hemorrhagic cyst at the ovarian \ntransposition site. After supportive care, the patient’s pain \nimproved, and she was discharged.\nIn December 2023, she revisited the emergency room \nbecause of the sudden development of severe acute abdom-\ninal pain. APCT revealed an increased 7.6 cm cyst with \n\n\nOvary transposition\n29\nhttps://medsci.jejunu.ac.kr/\nChul Min Park\ne-jmls.org\nseptations in the right ovary, raising the suspicion of ovar -\nian cyst torsion or a malignant cystic neoplasm. This led \nto a decision to perform laparoscopic surgery. During the \nprocedure, I encountered severe adhesions around the right \novarian transposition site and discovered a 7-8 cm endome-\ntrioma containing partially ruptured fluid. Consequently, a \nright oophorectomy was performed following adhesiolysis. \nAdditionally, an appendectomy was performed to prevent \nthe need for reoperation (Supplementary Video 1). The final \nhistological diagnosis confirmed an endometriotic cyst in \nthe right ovary, along with chronic inflammation and fi -\nbrosis in the appendix. After surgery, her pain disappeared \nwithout the need for further medication such as dienogest or \nother oral contraceptives.\nSurgery is uncommon in patients with tumors at the site \nof ovarian transposition during radical hysterectomy. Addi-\ntionally, dense adhesions are unavoidable because the ova -\nry is firmly fixed in its extrapelvic position. However, we \nfound that laparoscopic surgery for endometriomas at the \nsite of ovarian transposition was feasible. We believe that \nadhesion barrier products may help prevent adhesions after \novarian transposition. I hope that the video will be of great \nhelp to you (IRB No. 2024-07-031).\nCONFLICT OF INTEREST\nThe author reports no conflict of interest.\nFUNDING\nThis work was supported by the 2024 education, research \nand student guidance grant funded by Jeju National University.\nORCID\nChul Min Park, https://orcid.org/0000-0001-9338-9972\nREFERENCES\n  1. Covens AL, van der Putten HW, Fyles AW, Leung PM, O'Brien PF, \nMurphy KJ, et al. Laparoscopic ovarian transposition. Eur J Gynae-\ncol Oncol 1996;17:177-82.\n  2. Bisharah M, Tulandi T. Laparoscopic preservation of ovarian function: \nan underused procedure. Am J Obstet Gynecol 2003;188:367-70.\n  3. Moawad NS, Santamaria E, Rhoton-Vlasak A, Lightsey JL. Lapa-\nroscopic ovarian transposition before pelvic cancer treatment: ovar-\nian function and fertility preservation. J Minim Invasive Gynecol \n2017;24:28-35.\n  4. Pahisa J, Martínez-Román S, Martínez-Zamora MA, Torné A, Cap-\narrós X, Sanjuán A, et al. Laparoscopic ovarian transposition in patients \nwith early cervical cancer. Int J Gynecol Cancer 2008;18:584-9.","source_license":"CC0","license_restricted":false}