Surgical Approach to Laparoscopic and Robot-Assisted Ovarian Tissue Transplantation

Ovarian transplantation techniques evolved significantly since the first description of a laparoscopic orthotopic approach in 2000 by our team. The success of the ovarian tissue cryopreservation heavily depends on the transplantation techniques. Given the procedure is elective and often performed on recipients with numerous medical problems, a least invasive surgical approach should be taken. In addition, such an approach should provide the best chance for ovarian graft revascularization and primordial follicle survival. In this chapter we not only describe the most modern laparoscopic- and robot-assisted approaches to ovarian tissue harvesting and cryopreservation but we also offer details of our peri-operative and laboratory approaches and the use of the neovascularizing scaffolds to maximize the chance of success with ovarian tissue cryopreservation and transplantation. The step-by-step descriptions, coupled with the appendices in this book will enable those who are or will be performing this procedures to have a clear strategy to improve their success rates.