Pathologic findings and outcomes of a minimally invasive approach to ovarian remnant syndrome

Objective: To review outcomes and pathologic findings of a primarily minimally invasive approach to ovarian remnant syndrome. Design: Data were abstracted from medical records documenting bilateral salpingo-oophorectomy and subsequent treatment between 1996 and 2006 for pathologically confirmed ovarian remnant tissue. Follow-up was by mailed questionnaires and telephone interviews. Setting: Tertiary care academic medical institution. Patient(s): Twenty patients (mean age, 48 years) receiving treatment for ovarian remnant tissue after prior bilateral salpingo-oophorectomy. Intervention(s): Primarily minimally invasive approach (conventional laparoscopy and robot-assisted laparoscopy) for removal of ovarian remnant tissue. Main Outcome Measure(s): Postoperative complications and recurrence. Result(s): The 20 patients had a mean follow-up of 30 months. Indications were endometriosis in 8 and ovarian neoplasm in 6. Eighteen patients presented with pain, and 2 presented with a pelvic mass. Nineteen had laparoscopy (14 conventional; 5 robotic), and 1 had laparotomy. Remnant ovarian tissue was associated with endometriosis in 5 and corpus luteum in 3. Two patients had malignancy in remnant ovarian tissue. Postoperative complications included pneumonia (1 case). Follow-up identified no recurrence. Conclusion(s): Ovarian remnant syndrome can be managed safely and successfully with minimally invasive surgery. Risk of carcinoma mandates surgical resection.