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371 Laparoscopic pelvic peritonectomy and douglasectomy in stage IIb ovarian cancer
  1. Mikel Gorostidi1,
  2. Mar Rubio1,
  3. Paloma Cobas2,
  4. Ruben Ruiz2,
  5. Juan Cespedes2,
  6. Ibón Jaunarena3 and
  7. Arantza Lekuona4
  1. 1Hospital Universitario Donostia, San Sebastian, Spain
  2. 2Donostia University Hospital, Donosti, Spain
  3. 3Hospital Universitario Donostia, Donostia, Spain
  4. 4Hospital Universitario Donostia, Donostia/San Sebastian, Spain


Introduction/Background In ovarian cancer, it is essential to perform complete surgery without residue as part of the primary cytoreduction surgery.

The gold standard is open surgery; however, in selected cases the procedure can be performed laparoscopically.

Methodology A video is shown with the procedure to be performed to perform a peritonectomy of the lateral walls of the pelvis and the pouch of Douglas by laparoscopy.

To perform this procedure it is essential to develop the medial pararectal space (Okabayashi), respecting the mesoureter and not to damage the rectum muscle in the approach to the cul-de-sac of Douglas.

Results This case shows the finding of pelvic peritoneal involvement in a woman scheduled for laparoscopic staging after diagnosis of a high-grade endometrioid carcinoma of the ovary following laparoscopic salpingo-ophorectomy with deferred histological study due to an inconclusive adnexal tumor.

Once the laparoscopic staging was completed, this previously unnoticed affectation was visualized, so an exhaustive laparoscopic exploration was completed without further findings and it was decided to continue with a laparoscopic cytoreduction of this area.

Conclusion Laparoscopic peritonectomy and douglasectomy is a feasible procedure, and the technique of performing it both laparoscopically and open is fundamental. However, it is not the gold standard and should be performed only in selected cases, being essential to exclude other peritoneal involvement in an exhaustive manner, requiring in most situations an open approach.

Disclosures No disclosures.

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