Volume 11, Issue 3 (2026)
SJMR 2026, 11(3): 115-121 |
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Saremi A, Nateghi M R. A Novel Laparoscopic Technique for Fixation of the Utero-Ovarian Ligament to the Round Ligament for Prevention of Recurrent Ovarian Torsion: Experience from The Sarem Women’s Hospital. SJMR 2026; 11 (3) : 3
URL: http://saremjrm.com/article-1-405-en.html
URL: http://saremjrm.com/article-1-405-en.html
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
Abstract: (6 Views)
Introduction: Ovarian torsion is an important gynecologic surgical emergency caused by complete or partial rotation of the ovary around its supporting ligaments. This rotation may compromise or completely interrupt the blood supply, resulting in ovarian ischemia and, in severe cases, tissue necrosis. Timely diagnosis and appropriate surgical intervention play an important role in preserving ovarian and fallopian tube function. Although detorsion allows preservation of the ovary and fallopian tube in many cases, a previous episode of torsion is considered a predisposing factor for recurrent torsion. Oophoropexy is a surgical procedure used to fix the ovary or its supporting structures in order to reduce the risk of recurrent torsion.
Objective: The aim of this article is to introduce the laparoscopic oophoropexy technique used at Sarem Women’s Hospital, Tehran, for the prevention of recurrent ovarian torsion and to describe its surgical steps and technical considerations.
Technique Description: Following the diagnosis of ovarian torsion, detorsion is performed to restore blood flow to the ovary and fallopian tube, and the ovarian tissue is preserved whenever feasible. In the technique used at Sarem Women’s Hospital, Tehran, following detorsion, if the utero-ovarian ligament is excessively long, it is initially shortened or folded using a plication technique and is subsequently fixed to the round ligament. When the length of the utero-ovarian ligament and the ovarian supporting structures are within the normal range, fixation of the utero-ovarian ligament to the round ligament is performed directly. A zero-gauge Vicryl suture is used for fixation, and the needle passage is selected according to the position of the fallopian tube and through the avascular portion of the mesosalpinx to minimize the risk of fallopian tube injury or obstruction. In cases where there is a risk of loss of the contralateral ovary or a potential risk of recurrent torsion, contralateral oophoropexy is also performed.
Conclusion: Oophoropexy following detorsion may be considered a surgical approach for preventing recurrent ovarian torsion. The laparoscopic technique introduced at Sarem Women’s Hospital, Tehran, involving fixation of the utero-ovarian ligament to the round ligament, with plication of the utero-ovarian ligament, when necessary, provides an approach for stabilizing the ovarian position and reducing its mobility. A detailed description of this technique may improve surgeons’ familiarity with an available surgical option for preventing recurrent ovarian torsion.
Objective: The aim of this article is to introduce the laparoscopic oophoropexy technique used at Sarem Women’s Hospital, Tehran, for the prevention of recurrent ovarian torsion and to describe its surgical steps and technical considerations.
Technique Description: Following the diagnosis of ovarian torsion, detorsion is performed to restore blood flow to the ovary and fallopian tube, and the ovarian tissue is preserved whenever feasible. In the technique used at Sarem Women’s Hospital, Tehran, following detorsion, if the utero-ovarian ligament is excessively long, it is initially shortened or folded using a plication technique and is subsequently fixed to the round ligament. When the length of the utero-ovarian ligament and the ovarian supporting structures are within the normal range, fixation of the utero-ovarian ligament to the round ligament is performed directly. A zero-gauge Vicryl suture is used for fixation, and the needle passage is selected according to the position of the fallopian tube and through the avascular portion of the mesosalpinx to minimize the risk of fallopian tube injury or obstruction. In cases where there is a risk of loss of the contralateral ovary or a potential risk of recurrent torsion, contralateral oophoropexy is also performed.
Conclusion: Oophoropexy following detorsion may be considered a surgical approach for preventing recurrent ovarian torsion. The laparoscopic technique introduced at Sarem Women’s Hospital, Tehran, involving fixation of the utero-ovarian ligament to the round ligament, with plication of the utero-ovarian ligament, when necessary, provides an approach for stabilizing the ovarian position and reducing its mobility. A detailed description of this technique may improve surgeons’ familiarity with an available surgical option for preventing recurrent ovarian torsion.
Article number: 3
Keywords: Ovarian Torsion, Oophoropexy, Laparoscopy, Detorsion, Utero-ovarian ligament, Plication Procedure, Round ligament.
Article Type: Novel Techniques |
Subject:
Women Diseases
Received: 2026/09/10 | Accepted: 2026/09/14 | Published: 2026/09/17
Received: 2026/09/10 | Accepted: 2026/09/14 | Published: 2026/09/17
References
1. 1. Bandhon BZ, Rajadurai V, Johansson C. Ovarian Torsion in Normal Ovaries in Reproductive-Aged Women. Case Rep Obstet Gynecol. 2025;20256630642; 10.1155/crog/6630642; PMC12419912. [DOI:10.1155/crog/6630642] [PMID] [PMCID]
2. Bandhon B, Rajadurai V, Johansson C. Ovarian Torsion in Normal Ovaries in Reproductive‐Aged Women. Case Reports in Obstetrics and Gynecology. 2025;202510.1155/crog/6630642; [DOI:10.1155/crog/6630642] [PMID] [PMCID]
3. Huang C, Hong MK, Ding DC. A review of ovary torsion. Tzu Chi Med J. 2017;29(3): 143-47; 10.4103/tcmj.tcmj_55_17; PMC5615993. [DOI:10.4103/tcmj.tcmj_55_17] [PMID] [PMCID]
4. Bakar MA, Sjahid AS, Saáid AAM, Bakar MAA, Omar AA. Diagnosing ovarian torsion in the emergency department: A case report and literature review: Received 2024-02-13; accepted 2024-06-27; published 2025-01-02. Journal of Health and Translational Medicine (JUMMEC). 2025;28;85-88:(1).
5. Yousefi Z, Farazestanian M, Mottaghi M, Pourmoghadam N. Ovarian Torsion in Postmenopausal Women and risk of malignancy. Journal of Midwifery and Reproductive Health. 2015;3(4): 479-82; 10.22038/jmrh.2015.4811;
6. Agrawal T, Teh JJ, Bobotis S, Arsenaki E, Maxwell S, Kechagias KS, et al. Torsion of Tubo-Ovarian Complex during Pregnancy: A Case Report. Medicina. 2024;60(9): 1471; [DOI:10.3390/medicina60091471] [PMID] [PMCID]
7. Aksoy H, Ozyurt S, Aksoy U, Acmaz G, Karadag OI, Karadag MA. Ovarian torsion in puerperium: A case report and review of the literature. International Journal of Surgery Case Reports. 2014;5(12): 1074-76;
https://doi.org/10.1016/j.ijscr.2014.11.002 [DOI:10.1016/j.ijscr.2014.11.002;] [PMID] [PMCID]
8. Oyama K, Nakamoto K, Omori M, Fukasawa H, Hirata S. Prognostication of Ovarian Function after Ovarian Torsion Using Intraoperative Indocyanine Green Angiography. Journal of Minimally Invasive Gynecology. 2022;29(2): 237-42;
https://doi.org/10.1016/j.jmig.2021.08.003 [DOI:10.1016/j.jmig.2021.08.003;] [PMID]
9. Akdam A, Bor N, Fouks Y, Ram M, Laskov I, Levin I, et al. Recurrent Ovarian Torsion: Risk Factors and Predictors for Outcome of Oophoropexy. J Minim Invasive Gynecol. 2022;29(8): 1011-18; 10.1016/j.jmig.2022.05.007; [DOI:10.1016/j.jmig.2022.05.007] [PMID]
10. Kanna E, Lamprinou Z, Panayiotou D, Batsari E, Skondras I. Recurrent Ovarian Torsion in a Premenarchal Girl Managed With Laparoscopic Round Ligament Oophoropexy: A Case Report. Cureus. 2026;18:(6) [DOI:10.7759/cureus.110206]
11. Hartley J, Akhtar M, Edi-Osagie E. Oophoropexy for Recurrent Ovarian Torsion. Case Rep Obstet Gynecol. 2018;20188784958; 10.1155/2018/8784958; PMC5818957. [DOI:10.1155/2018/8784958] [PMID] [PMCID]
12. Varra F-N, Fasoulopoulos A, Spathi E, Tzirou O, Varra V-K, Varras M. Ultrasonographic whirlpool sign in ovarian torsion with dual mature teratomas: A case report and literature review. Med Int. 2026;6(4): 38; 10.3892/mi.2026.322; [DOI:10.3892/mi.2026.322] [PMID] [PMCID]
13. Ke K, Conrad D, Cario G. Conservative Management of Ovarian Torsion. Gynecology & Obstetrics. 2020;10
14. Fuchs N, Smorgick N, Tovbin Y, Ben Ami I, Maymon R, Halperin R, et al. Oophoropexy to prevent adnexal torsion: how, when, and for whom? J Minim Invasive Gynecol. 2010;17(2): 205-8/10/1016; j.jmig.2009.12.011; [DOI:10.1016/j.jmig.2009.12.011] [PMID]
15. Nogaj Z, Januszkiewicz-Lewandowska D, Kaźmierowska A, Jurczok M, Mańkowski P, Sosnowska-Sienkiewicz P. Should oophoropexy be a standard procedure after ovarian torsion in premenarchal patients? A case-based review of fixation indications and techniques. European Journal of Clinical and Experimental Medicine. 2026;2410.15584/ejcem.2026.2.6; [DOI:10.15584/ejcem.2026.2.6]
16. Yagur Y, Klein A, Tiosano L, Weitzner O, Daykan Y, Rosen D, et al. Comparative outcomes of oophoropexy techniques in preventing recurrent adnexal torsion. Arch Gynecol Obstet. 2025;312(4): 1317-25; 10.1007/s00404-025-08128-x; PMC12414049. [DOI:10.1007/s00404-025-08128-x] [PMID] [PMCID]
17. Smorgick N, Mor M, Dovev MN, Eisenberg N, Vaknin Z. Combined Utero-Ovarian and Round Ligament Oophoropexy for Recurrent Torsion of Normal Adnexa: A Case Series. Journal of Pediatric and Adolescent Gynecology. 2023;36(5): 484-87;
https://doi.org/10.1016/j.jpag.2023.06.006 [DOI:10.1016/j.jpag.2023.06.006;] [PMID]
18. Mandarano G, Gazzaneo M, Bosisio M, Parolini F, De Previde Prato D, Boroni G, et al. Role of oophoropexy in pediatric primary ovarian torsion without adnexal lesions: A systematic review and meta-analysis. Journal of Pediatric Surgery. 2026;61(4): 162938;
https://doi.org/10.1016/j.jpedsurg.2026.162938 [DOI:10.1016/j.jpedsurg.2026.162938;] [PMID]
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