Correction
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Dissection for removal of the ovarian remnant should start with opening of the retroperitoneal space at the pelvic brim with early identification of the ureter and the anterior division of the hypogastric artery. Each is then further isolated to determine its involvement with the ovarian remnant. The ureter is almost always densely ad- herent laterally to the mass. However, if the mass extends further inferiorly and laterally into the hypogastric artery or its branches, we believe resection of the involved hy- pogastric system en bloc with the mass is the safest way to proceed. This approach accomplishes 3 things, as follows: (1) It lowers the risk of vascular injury and keeps the op- erative field clear of blood; (2) it facilitates retraction on the mass, making ureterolysis easier; (3) finally, it ensures that functional ovarian tissue will not be left behind deep in the retroperitoneal space. Successful surgery for ovarian remnant syndrome re- quires radical resection of the remnant and surrounding structures. When the remnant involves the hypogastric artery or its branches, resection of this vascular system en- sures complete and safe removal of the remnant. REFERENCES 1. Lafferty HW, Angioli R, Rudolph J, Penalver MA. Ovarian rem- nant syndrome: Experience at Jackson Memorial Hospital, Uni- versity of Miami, 1985 through 1993. Am J Obstet Gynecol 1996;174:641-5. 2. Berek JS, Damey PD, Lopkin C, Goldstein DP. Avoiding ureteral damage in pelvic surgery for ovarian remnant syndrome. Am J Obstet Gynecol 1979;133:221-2. 236 Unger and Paul January 2001 Am J Obstet Gynecol Correction In “The American Board of Obstetrics and Gynecology, Inc: Approved fellowship training programs in obstetrics and gynecology subspecialties–Gynecologic Oncology, Reproductive Endocrinology/Infertility, Maternal-Fetal Medi- cine, and Female Pelvic Medicine and Reconstructive Surgery” (Am J Obstet Gynecol 2000;183(5):30A-4A), one of the programs was inadvertently omitted. Under the Maternal-Fetal Medicine subspecialty the following should have appeared on page 33A: CATEGORY State: City Institution Number of approved positions Director of program MATERNAL-FETAL MEDICINE New Jersey: Newark UMDNJ/New Jersey Med School 1 per year, alt 0, alt 1 (total 2) Joseph J. Apuzzio
Transcript of Correction
Dissection for removal of the ovarian remnant shouldstart with opening of the retroperitoneal space at thepelvic brim with early identification of the ureter and theanterior division of the hypogastric artery. Each is thenfurther isolated to determine its involvement with theovarian remnant. The ureter is almost always densely ad-herent laterally to the mass. However, if the mass extendsfurther inferiorly and laterally into the hypogastric arteryor its branches, we believe resection of the involved hy-pogastric system en bloc with the mass is the safest way toproceed. This approach accomplishes 3 things, as follows:(1) It lowers the risk of vascular injury and keeps the op-erative field clear of blood; (2) it facilitates retraction onthe mass, making ureterolysis easier; (3) finally, it ensures
that functional ovarian tissue will not be left behind deepin the retroperitoneal space.
Successful surgery for ovarian remnant syndrome re-quires radical resection of the remnant and surroundingstructures. When the remnant involves the hypogastricartery or its branches, resection of this vascular system en-sures complete and safe removal of the remnant.
REFERENCES
1. Lafferty HW, Angioli R, Rudolph J, Penalver MA. Ovarian rem-nant syndrome: Experience at Jackson Memorial Hospital, Uni-versity of Miami, 1985 through 1993. Am J Obstet Gynecol1996;174:641-5.
2. Berek JS, Damey PD, Lopkin C, Goldstein DP. Avoiding ureteraldamage in pelvic surgery for ovarian remnant syndrome. Am JObstet Gynecol 1979;133:221-2.
236 Unger and Paul January 2001Am J Obstet Gynecol
CorrectionIn “The American Board of Obstetrics and Gynecology, Inc: Approved fellowship training programs in obstetrics
and gynecology subspecialties–Gynecologic Oncology, Reproductive Endocrinology/Infertility, Maternal-Fetal Medi-cine, and Female Pelvic Medicine and Reconstructive Surgery” (Am J Obstet Gynecol 2000;183(5):30A-4A), one ofthe programs was inadvertently omitted. Under the Maternal-Fetal Medicine subspecialty the following should haveappeared on page 33A:
CATEGORYState: City
Institution Number of approved positions Director of program
MATERNAL-FETAL MEDICINENew Jersey: Newark
UMDNJ/New Jersey Med School 1 per year, alt 0, alt 1 (total 2) Joseph J. Apuzzio
