Single incision laparoscopic surgery SILS for ovarian tissue

Single incision laparoscopic surgery (SILS) for ovarian tissue cryopreservation LOGO Gilad Karavani 1, Natali Schachter-Safrai 1, Henry H Chill 1, Talya Mordechai Daniel 2, Dvora Bauman 1, Ariel Revel 1 Study Objective: To present single-incision laparoscopic surgery (SILS) as an alternative to standard multi-port laparoscopic surgery (MPLS) for ovarian tissue cryopreservation (OTC). Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Tertiary medical center. Patients: Two hundred thirty-one patients referred for oncological fertility preservation. Intervention: Non-inferiority comparison of SILS to MPLS for ovarian cryopreservation for future transplantation. Parameter SILS (n=66) MPLS (n=163) OR (95% CI) P value Partial oophorectomy 18 (27. 3%) 50 (30. 3%) 0. 85 (0. 45 -1. 60) 0. 61 1. 2. Port insertion Bone marrow aspiration Duration of OTC Overall Complications Intra- 23 (34. 8%) 41 (25. 1%) 1. 59 (0. 86 -2. 95) 0. 14 6 (9. 1%) 19 (11. 5%) 0. 76 (0. 29 -1. 99) 0. 57 70. 8± 23. 3 69. 2± 45. 7 N/A 0. 79 3 (4. 6%) 3(1. 8%) 2. 54 (0. 50 -12. 92) 0. 26 operativea 1 (1. 5%) 1 (0. 6%) 2. 49 (0. 15 -40. 44) 0. 52 Post- operativeb 2 (3. 0%) 2 (1. 2%) 2. 52 (0. 35 -18. 24) 0. 36 3. 4. 5. CONCLUSIONS Hospital stay (days) after Our findings suggest that SILS is an interesting alternative to MPLS. Future prospective trials may prove some benefit in ovarian tissue volume or time until chemotherapy initiation. OTC 1. 14± 0. 61 1. 13± 0. 60 N/A 0. 87 N of oocytes (day 0) 8. 0± 7. 8 8. 8± 8. 1 N/A 0. 5 N of ampules extractedc 14. 7± 3. 7 10. 6± 3. 9 N/A <0. 001 arielr@asaf. health. gov. il Printed by Donnez J, S Bassil S. Indications for cryopreservation of ovarian tissue. Hum Reprod. 1998; 4: 248 -59. Kikuchi I, Kagawa N, Silber S, et al. Oophorectomy for fertility preservation via reducedport laparoscopic surgery. Surg Innov. 2013; 20: 21924. Meirow D, Fasouliotis SJ, Nugent D, Schenker JG, Gosden RG, Rutherford AJ. Laparoscopic technique for obtaining ovarian cortical biopsy specimens for fertility conservation in patients with cancer. Fertil Steril. 1999; 71: 948– 51. Revel A, Laufer N, Meir A Ben, Lebovich M, Mitrani E. Micro-organ ovarian transplantation enables pregnancy: A case report. Hum Reprod. 2011; 26: 1097– 103. Markar SR, Karthikesalingam A, Thrumurthy S, Muirhead L, Kinross J, Paraskeva P. Single incision lap surgery (SILS ) vs. conventional multipo rt cholecystectomy: syste matic review and metaanalysis. Surg Endosc. 2012; 26: 120513.