Ovarian drilling

Ovarian drilling is a surgical technique of puncturing the membranes surrounding the ovary with a laser beam or an surgical needle using minimally invasive laparoscopic procedures. It differs from ovarian wedge resection, because resection involves the cutting of tissue. Ovarian drilling and ovarian wedge resection are performed to reduce the amount of androgen producing tissue in women with polycystic ovarian syndrome. Ovarian drilling is often preferred to incision because cutting in to the ovary can cause adhesions which may complicate postoperative outcomes.^[1]

Ovarian drilling is a laparoscopic surgical technique that is used to reduce the amount of androgen producing tissue in women. The women who are usually candidates for this type of treatment have polycystic ovarian syndrome. Ovarian drilling is often preferred to ovarian wedge resection because ovarian web resection involves the use of instrumentation which sometimes results in the formation of adhesions. Ovarian drilling reduces the potential for adhesions formation. Ovarian drilling was first developed after 1980.^[1]

Ovarian drilling has lower rates of ovarian hyper-stimulation syndrome and of multi-fetal gestation. Though preferable to creating incisions on the ovary, ovarian drilling have some risks. These are: pelvic adhesion formation, long-term ovarian function, developing hyperstimulation syndrome, adhesion formation, infertility and multiple births.^[2]

Procedures

When the clinician determines that ovarian drilling is appropriate and the woman decides to undergo this treatment, consent is obtained. The risks are communicated to the woman.^[1]

Common instrumentation consists of the use of a bipolar electrical surgical electrodes or a CO₂, argon, or ND-YAG laser. This instrumentation has the ability to produce the intended results with a very focal approach. The number of punctures to the ovary done by the surgeon are usually 4-10mm deep and 2-4mm wide. The number of punctures is related to to subsequent ability to conceive. It has been found that five to ten punctures are more likely to produce the intended conception.^[1]

Risks

Ovarian drilling have some risks. These are: pelvic adhesion formation, long-term ovarian function, developing hyperstimulation syndrome, adhesion formation, infertility and multiple births.^[1]^[2]

References

1 2 3 4 5 Hoffman, Barbara (2012). Williams gynecology. New York: McGraw-Hill Medical. ISBN 9780071716727.
1 2 Lebbi, Issam; Ben Temime, Riadh; Fadhlaoui, Anis; Feki, Anis (2015). "Ovarian Drilling in PCOS: Is it Really Useful?". Frontiers in Surgery 2. doi:10.3389/fsurg.2015.00030. ISSN 2296-875X.

Medicine: Pathology

Principles of pathology	Disease Infection Neoplasia Etiology Pathogenesis Hemodynamics Ischemia Inflammation Cell damage Wound healing Cellular adaptation Atrophy Hypertrophy Hyperplasia Dysplasia Metaplasia Squamous Glandular Cell death Necrosis Coagulative necrosis Liquefactive necrosis Gangrenous necrosis Caseous necrosis Fat necrosis Fibrinoid necrosis Programmed cell death Apoptosis Pyknosis Karyorrhexis Karyolysis Accumulations pigment Hemosiderin Lipochrome/Lipofuscin Melanin Steatosis

Anatomical pathology	Surgical pathology Cytopathology Autopsy Molecular pathology Forensic pathology Oral and maxillofacial pathology Gross examination Histopathology Immunohistochemistry Electron microscopy Immunofluorescence Fluorescence in situ hybridization

Clinical pathology	Clinical chemistry Hematopathology Transfusion medicine Medical microbiology Diagnostic immunology Immunopathology Enzyme assay Mass spectrometry Chromatography Flow cytometry Blood bank Microbiological culture Serology

Specific conditions	Myocardial infarction

Wound healing

Blood vessels	Angiogenesis Intussusception Vasculogenesis

Other	Fibrosis Maggot therapy Granulation tissue Growth factor Scar Stem cell

This article is issued from Wikipedia - version of the Saturday, February 06, 2016. The text is available under the Creative Commons Attribution/Share Alike but additional terms may apply for the media files.