Opportunistic salpingectomy

Why?

The SAC Technique advocates performing opportunistic bilateral salpingectomy in cases of PAS hysterectomy. High grade serous carcinoma accounts for 70% of all ovarian cancers, with recent understanding identifying occult disease within the fallopian tube as the potential origin of this disease cascade.

When compared with tubal ligation in the general (non-high risk) population, studies have demonstrated a relative 29.2% risk reduction in ovarian cancer cases when salpingectomy is instead performed.

How?

By using the Ligasure Impact device (Medtronic, UK) to detach the tubes from the mesosalpinx efficiently and with good haemostasis.