Ovarian suspension for adhesion prevention during laparoscopic excision of severe pelvic endometriosis and endometrioma excision: a systematic review

Ovarian adhesions are fibrous connections, which develop between the ovaries and the surrounding organs as a result of a prior traumatic surgery in this area. Several studies suggest ovarian suspension as a way to prevent them; however, to date, there is no consensus regarding its effectiveness in the field. To investigate whether the application of ovarian suspension would be beneficial in the prevention of postoperative ovarian adhesions. We used Medline (1966–2015), Scopus (2004–2015), ClinicalTrials.gov (2008–2015), Cochrane Central Register of Controlled Trials (CENTRAL; 1999–2015), and Google Scholar (2004–2015) search engines in our primary search, together with reference lists from included studies. Four studies were included in our systematic review, which recruited 105 women of fertile age. The rates of absence of adhesions were between 41 and 80 %. In their majority, adhesions were mild whenever reported, with the exception of the study of Ouahba et al. who found that adhesions of moderate severity had an incidence of 33 %. None of the included studies reported the incidence of preoperative and postoperative symptoms. Current evidence suggests that ovarian suspension could be an effective and feasible surgical technique, which might actually help reduce postoperative adhesions. However, future research is needed in this field, as the number of studies published in this field is relatively small to reach firm conclusions. Similar content being viewed by others

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Fertil Steril 104:119–123.e111 Centini G, Afors K, Murtada R et al (2015) The impact of laparoscopic surgical management of deep endometriosis on pregnancy rate. J Minim Invasive Gynecol Author information Authors and Affiliations Corresponding author Ethics declarations Funding The authors did not receive funding for the present study. Conflict of interest The authors declare that they have no conflict of interest. Ethical approval This article does not contain any studies with human participants or animals performed by any of the authors. Rights and permissions About this article Cite this article Pergialiotis, V., Prodromidou, A., Karampetsou, N. et al. Ovarian suspension for adhesion prevention during laparoscopic excision of severe pelvic endometriosis and endometrioma excision: a systematic review. Gynecol Surg 13, 445–450 (2016). https://doi.org/10.1007/s10397-016-0963-3 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s10397-016-0963-3