Video Objective: This video is intended for any benign gynecologic surgeon who is performing risk-reducing surgery in their practice. We intend to review the “best practices” recommended by ACOG when performing a risk-reducing bilateral salpingo-oophorectomy (RR-BSO) in patients with Hereditary Breast and Ovarian Cancer Syndrome.
Interventions: This video describes the case of a 36-year-old female diagnosed with a BRCA 1 mutation who has completed childbearing and desires RR-BSO. The elements that are critical to include in risk-reducing procedures include: 1. A thorough visualization of all peritoneal surfaces and accessible intraperitoneal organs should be performed. 2. Washings should be obtained. 3. All tissue from the ovaries should be removed, and the fallopian tubes should be removed at their uterine insertion point. 4. Complete serial sectioning of the ovaries and fallopian tubes is necessary by pathology, with microscopic examination for occult cancer.
Conclusion: These “best practices” should be employed by all surgeons when performing a RR-BSO in order to most effectively increase detection of early neoplastic changes and occult malignancy, and decrease their patient’s risk of developing ovarian and fallopian tube cancer.
