Robot-assisted laparoscopic auto-graft of patchwork ovarian cortex in two steps

J Gynecol Obstet Hum Reprod. 2020 Sep;49(7):101730. doi: 10.1016/j.jogoh.2020.101730. Epub 2020 Mar 28.

Abstract

The main difficulty of ovarian tissue autograft (OTA) is to preserve as many follicles as possible because the ovarian tissue undergoes warm ischemia during grafting until revascularisation, resulting in significant follicular loss. We describe a two-stage grafting technique to stimulate new vascularisation in order to enhance the revascularization process to reduce the ischemic injuries. Furthermore we performed ovarian patchwork in the laboratory and then grafting with robotic laparoscopy to facilitate surgery and increase precision. This technique is used in the DATOR study with promising results, such as a 40% delivery rate.

Keywords: Birth; Cancer; Infertility; Ischemia; Ovarian tissue autograft; Robotic.

MeSH terms

  • Autografts
  • Cryopreservation
  • Female
  • Fertility Preservation
  • Humans
  • Laparoscopy / methods
  • Ovary / transplantation*
  • Pregnancy
  • Primary Ovarian Insufficiency / etiology
  • Primary Ovarian Insufficiency / surgery
  • Robotic Surgical Procedures / methods*