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. 2023 Sep;66(5):459-461.
doi: 10.5468/ogs.23029. Epub 2023 Jun 29.

The application of pringle manoeuvre, type three liver mobilisation, full thickness diaphragmatic resection with primary closure technique and peritonectomy in the management of advanced ovarian malignancy

Sarah Louise Smyth  1 , Hooman Soleymani Majd  1
Affiliations

The application of pringle manoeuvre, type three liver mobilisation, full thickness diaphragmatic resection with primary closure technique and peritonectomy in the management of advanced ovarian malignancy

Sarah Louise Smyth et al. Obstet Gynecol Sci. 2023 Sep.

Abstract

Objective: We present an educational technique for the safe completion of complete cytoreduction of diaphragmatic disease for the management of advanced ovarian malignancy.

Methods: We demonstrated these steps with attention to anatomical landmarks and surgical approaches, considering intraoperative and postoperative morbidity and mortality.

Results: We present the case of a 49-year-old female patient diagnosed with suspected stage 3C ovarian malignancy following diagnostic laparoscopy. We demonstrate the surgical application of the Pringle manoeuvre, type 3 liver mobilisation, and full-thickness diaphragmatic resection. This was completed with a primary closure technique, with integrity ensured through the performance of an air test and Valsalva manoeuvre. Final histology confirmed a serous borderline tumour with invasive implants within a port site nodule (stage 4A).

Conclusion: This technique affirms the essential skills in gynaecological oncology training and details a challenging case requiring advanced surgical skills and knowledge, with specific consideration for intraoperative multidisciplinary decision-making.

Keywords: Cytoreduction; Diaphragmatic resection; Liver mobilisation; Peritonectomy; Pringle manoeuvre.

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Conflict of interest statement

Conflict of interest

No conflict of interest declared.

Figures

Fig. 1
Fig. 1
Advanced energy device excising full thickness diaphragmatic nodules to include pleurectomy, ensuring appropriate macroscopic excision margins.
See this image and copyright information in PMC

References

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