Exploratory incision of the ovary

Exploratory incision of the ovary

There are two good reasons for incising the capsule of the ovary and exploring its interior when one or both ovaries are to be left in place, regardless of whether the uterus is removed.

Exploratory incision of the ovary – manual for the surgeon:

So much of the disease one finds in the ovary tends to occur bilaterally that the surgeon should know what the interior of the ovary looks like when he is removing one adnexa and leaving the other. It is amazing how often disease can be found in the interior of an ovary that appears, on gross examination of the exterior, to be normal.

Exploratory incision of the ovary

The second reason concerns itself with ovaries that are to be left in situ following the removal of the uterus for benign disease. There is a tendency to remove both ovaries at the time of hysterectomy regardless of the age of the patient because of the possibility that benign or malignant tumors may later develop in them. The authors are not in sympathy with this point of view. We are in favor of preserving ovarian function unless there is a valid reason for removing both ovaries. If the retained ovaries are sectioned and no gross lesion seen, they are unlikely to develop disease within them at a later date.

operations on the uterus and adnexa

Figure 5. The ovary is steadied between the index and middle fingers of the operator’s left hand, and a linear incision is made in the long axis and carried directly into the substance of the ovary almost to the hilum.

Figure 6. The two cross sections are thus exposed. The interior of the ovary is inspected, and any suspicious area or cyst is excised for pathological examination.

Figure 7. The ovary is reconstructed with a running atraumatic suture up and back.

for pathological examination

 

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