1. 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

3. 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

4. Based on modelling study No evidence No RCT’s No case control studies No cohort studies

5. FOR Ovarian Cancer Less tubal- related reasons for reoperation Pelvic pain Implications on future imaging No benefit with tubal retention

6. AGAINST Insufficient evidence Early menopause Intra- operative complications Longer operative time Post - operative recovery

7. Methodology Validated online survey to all RANZCOG fellows Objective To assess current practice RANZCOG statement C-25 Consideration be given and discussed with patient

8. 26% response 1490 382 366

9. Designation

10. Primary place of practice

11. Years of clinical practice

12. Type of specialist

13. Do you discuss or offer opportunistic bilateral salpingectomy during gynaecological surgery for benign indications with ovarian preservation (in a low risk population)?

14. Which situations would you offer RRS

15. WHY do you offer opportunistic bilateral salpingectomy - state the single most appropriate reason why.

16. If you do not offer opportunistic bilateral salpingectomy, the single most appropriate reason why.

17. Survey Summary 70% would offer and discuss RRSMost offered at AH and LH

18. Future directions Further research to define protective effect and surgical outcomes Role of registry and method of long term follow up

19. Thank you