58900 Biopsy of ovary, unilateral or bilateral (separate procedure)

Name of the Procedure:

Biopsy of Ovary, Unilateral or Bilateral
Common name(s): Ovarian Biopsy
Technical/medical term: Oophorectomy biopsy

Summary

An ovarian biopsy involves removing a small tissue sample from one or both ovaries to be examined under a microscope. This procedure is usually performed to diagnose or rule out diseases such as ovarian cancer or other abnormalities.

Purpose

The primary purpose of an ovarian biopsy is to diagnose or rule out ovarian cancer, benign tumors, and other ovarian conditions. It helps in identifying cellular abnormalities and assists in guiding further treatment.

Indications

• Persistent pelvic pain or abnormal swelling
• Suspicion of ovarian cancer based on imaging studies (e.g., ultrasound, MRI)
• Unexplained infertility
• Abnormal results from blood tests (e.g., CA-125 levels)
• Ovarian cysts or masses that require further investigation

Preparation

• Patients may need to fast for at least 6-8 hours before the procedure.
• Medications such as blood thinners may need to be adjusted.
• Pre-procedure tests could include blood work, imaging studies, and medical history review.
• Patients should arrange for transportation as they may not be able to drive post-procedure.

Procedure Description

1. The patient is positioned on the operating table.
2. General or local anesthesia is administered to ensure patient comfort.
3. A small incision is made in the lower abdomen (laparotomy) or a laparoscope is used (minimally invasive).
4. A sample of ovarian tissue is removed using surgical tools.
5. The tissue sample is sent to a laboratory for pathological examination.

6. Incisions are closed with sutures or surgical glue.

   Tools & Equipment: Laparoscope, scalpel, biopsy needle, sutures.
   Anesthesia: General anesthesia or local with sedation.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure can be performed in a hospital, outpatient surgical center, or specialized clinic equipped with surgical facilities.

Personnel

• Surgeon (Gynecologist or Oncologist)
• Anesthesiologist
• Surgical nurses and technicians
• Pathologist (for tissue examination)

Risks and Complications

• Common risks: Bleeding, infection at the incision site, pain, or minor complications from anesthesia.
• Rare risks: Injury to nearby organs, excessive bleeding, allergic reactions to medications, and scar tissue formation (adhesions).

Benefits

• Accurate diagnosis of ovarian conditions
• Guiding effective treatment plans
• Early detection of malignant conditions, which can improve outcomes

Recovery

• Patients may need to stay in the recovery room for several hours post-procedure for observation.
• Mild pain and discomfort can be managed with prescribed pain medications.
• Most patients can resume normal activities within 1-2 weeks, with some restrictions on heavy lifting.
• Follow-up appointments to discuss biopsy results and further treatment.

Alternatives

• Imaging studies (ultrasound, CT scan, MRI) can provide information but may not offer a definitive diagnosis.
• Blood tests (e.g., CA-125) provide indications but lack specificity.
• Non-invasive procedures like watchful waiting with regular monitoring may be recommended in some cases.

Pros and Cons of Alternatives:

• Pros: Less invasive, fewer risks.
• Cons: May not provide as accurate a diagnosis, potentially delaying necessary treatment.

Patient Experience

During the procedure, patients are under anesthesia and should feel no pain. Post-procedure, patients might experience mild pain or discomfort at the incision site, which can be managed with pain relievers. Comfort measures include rest, pain management, and following post-operative care instructions provided by the healthcare team.