DR. S KAPURUBANDARA 1,2, DR. V QIN 3,5, DR. D GURRAM 1,5, DR. A ANPALAGAN 1, A/PROF H MERKUR 3, 5, A/PROF R HOGG 2, 4, DR. A BRAND 2, 4 1 O&G DEPARTMENT, WESTMEAD HOSPITAL 2 UNIVERSITY OF SYDNEY 3 SYDNEY WEST ADVANCED PELVIC SURGERY 4 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 pain Implications 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 Objective To assess current practice RANZCOG statement C-25 Consideration be given and discussed with patient

26% response

Designation

Primary place of practice

Years of clinical practice

Type of specialist

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

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 RRSMost 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