Bilateral Laparoscopic Transperitoneal Ligation of Ovarian Veins for Treatment of Pelvic Congestion Syndrome

In: The Journal of the American Association of Gynecologic Laparoscopists · 2003 · vol. 10(4) , pp. 501–504 · doi:10.1016/s1074-3804(05)60156-9 · PMID:14738638 · W2054003241
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This paper describes a laparoscopic transperitoneal approach for bilateral ovarian vein ligation as a treatment for pelvic congestion syndrome.

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Abstract

Study objectiveTo evaluate the efficacy and safety of bilateral laparoscopic transperitoneal ligation of the ovarian veins in women with symptomatic pelvic varices.DesignProspective pilot study performed in a small series (Canadian Task Force classification III).SettingUrban hospital in Turin and University hospital in Cagliari, Italy.PatientsTwenty-three women.InterventionBilateral laparoscopic transperitoneal ligation of the ovarian veins. The right ovarian vein was reached by incising posterior peritoneum below the mesentericoparietal fossa in all women. The left ovarian vein was reached by reflecting medially the left colon in 10 women and by incising the posterior peritoneum covering the aorta 2 cm below the inferior duodenal fold in 13.Measurements and main resultsAfter the plateau of the learning curve was reached, average operating time was about 60 minutes without complications. Complete remission of pain and absence of pelvic varicosities lasted for 12 months.ConclusionThe laparoscopic transperitoneal paraaortic approach to bilateral ligation of ovarian veins near their origin could be a new treatment option for pelvic congestion syndrome.

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