Omentopexy as a novel adjunct to detorsion in ovarian torsion: experimental evidence

Abstract

Objective: In the treatment of ovarian torsion, the primary goal is to preserve the ovary through detorsion, even when it appears blue-black. However, no routinely applied method currently exists to prevent ischemia-reperfusion (I/R ) injury that occurs after detorsion. The aim of this study is to evaluate the effect of wrapping the detorsioned ovary with omentum in preventing I/R associated tissue damage

Materials and Methods: Fifteen Sprague–Dawley rats were randomly assigned to three groups (n = 5 each). In the sham group, laparotomy was performed, and the abdomen was closed without further intervention. In the control group, the left ovary was rotated 720° clockwise and fixed to the anterior abdominal wall, followed by omentectomy. After 24 hours, laparotomy was repeated and the ovary was detorsioned. In the experiment group, the left ovary was rotated 720° clockwise and fixed to the anterior abdominal wall. After 24 hours, laparotomy was repeated, the ovary was detorsioned, and then wrapped in omentum. Twenty-one days after the first surgery, oophorectomy was performed in all groups. Ovarian tissues were histopathologically examined for congestion, interstitial edema, neutrophilic infiltration, and necrosis, and overall tissue damage scores were calculated.

Results: There was no significant difference between the sham and experiment groups regarding overall tissue damage (p = 0.171). However, the control group had significantly higher tissue damage compared to the sham group (p = 0.001). Necrosis was observed in two ovaries of the control group, whereas no necrosis was seen in the sham or experimental groups. Viable follicles were detected in only two rats in the control group, while all rats had viable follicles in the sham and experiment groups.

Conclusion: Omentopexy was found to be effective in tissue healing. Wrapping the ovary with omentum after detorsion may help preserve ovarian function and maintain follicular viability.