DR. S KAPURUBANDARA1,2, DR. V QIN3,5, DR. D GURRAM1,5 , DR. A ANPALAGAN1, A/PROF H MERKUR3, 5, A/PROF R HOGG2, 4, DR. A BRAND2, 4

1 O&G DEPARTMENT, WESTMEAD HOSPITAL2 UNIVERSITY OF SYDNEY

3 SYDNEY WEST ADVANCED PELVIC SURGERY4 GYNAEONCOLOGY DEPARTMENT, WESTMEAD HOSPITAL

5 UNIVERSITY OF WESTERN SYDNEY,

SURVEY TO ASSESS CURRENT PRACTICE AND FACTORS AFFECTING CLINICIANS’ DECISION TO PERFORM

OPPORTUNISTIC BILATERAL SALPINGECTOMY DURING GYNAECOLOGICAL SURGERY FOR BENIGN DISEASE

OVCARE – British Columbia

• Sept 2010 Media release : “ovarian cancer related deaths can be reduced by 40%”

• RRS at hysterectomy

• RRS for permanent sterilization

• Genetic testing for HG serous cancers

Based on modelling study

No evidence

No RCT’s

No case control studies

No cohort studies

FOR

Ovarian Cancer

Less tubal-related

reasons for reoperation

Pelvic painImplications

on future imaging

No benefit with tubal retention

AGAINST

Insufficient evidence

Early menopause

Intra-operative

complications

Longer operative

time

Post -operative recovery

Methodology

Validated online survey to all RANZCOG fellows

ObjectiveTo assess current practice

RANZCOG statement C-25 Consideration be given and discussed with patient

26% response

1490

382

366

Designation

VMO Staff specialist Fellow Other (please specify)

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

48%

26%

21%

5%

VMO Staff specialist

Fellow Other (please specify)

Primary place of practice

Years of clinical practice

1-5 6-10 11-15 16-20 21-25 26-30 ≥ 310%

5%

10%

15%

20%

25%23%

11%

17%

12%

8%

13%

17%

Type of specialist

Gener

alist

Gynae

colo

gist

Obste

tricia

n

Urogy

naec

olog

ist (C

U)

Gynae

onco

logi

st (.

..

CMFM

Lapa

rosc

opic

Surg

eon

CREI

COGU0%

10%

20%

30%

40%

50%

60%

70%

80%

67%

17%

1% 2%5%

0%

5%3%

1%

Do you discuss or offer opportunistic bilateral salpingectomy during gynaecological surgery for benign indications with ovarian preservation (in a low risk population)?

Which situations would you offer RRS

AH LH VH Abdo Sx Lap Sx Lap Steri TL at CS0%

20%

40%

60%

80%

100%

120%

96%

76%

28%

57%49%

42%

25%

WHY do you offer opportunistic bilateral salpingectomy - state the single most appropriate reason why.

If you do not offer opportunistic bilateral salpingectomy, the single most appropriate reason why.

Survey Summary

70% would offer and discuss RRS

Most offered at AH and LH

Future directions

Further research to define protective effect and surgical outcomes

Role of registry and method of long term follow up

Thank you