Impact of Laparoscopic Ovarian Drilling on Ovarian Reserve in Patients With Anovulatory Polycystic Ovarian Syndrome
Condition: Polycystic Ovary Syndrome
MeSH terms: Polycystic Ovary Syndrome; Syndrome
Study type: Interventional

Summary: 
      Pneumoperitoneum is done by insertion of the verress needle at the inferior edge of the
      umbilicus putting into consideration the following tests:

        1. Needle test: Verress needle patency check.

        2. Hissing phenomenon: Needle introduced by open valve mechanism.

        3. Aspiration test: Placing a drop of water on the opening of the needle and examine its
           disappearance into the abdomen.

        4. Volume test: Changes occurred in the intra abdominal pressure during gas insufflations.

      Intra abdominal pressure 12-16 mmHg usually suitable for this pelvic surgery. Introduction of
      the laparoscopic instruments all in its place

        -  Laparoscopic telescope : From the inferior edge of umbilicus through trocar and sleeve
           which inserted by corkscrew technique then removed to allow the telescope insertion
           which connected to light source , camera head and color monitor.

        -  2nd and 3rd punctures were done allowing another two graspers to be inserted usually at
           a point represent outer 1/3 of the lateral abdominal wall in an imaginary line from
           umbilicus to iliac bone

      Puncturing technique :

      Fixation of one ovary away from intestine by grasping the ovarian ligament with the traumatic
      grasper which allow good exposure of the ovary and allow drilling .

      Drilling needle was introduced and connected by monopolar current, held against ovarian
      surface for 4 seconds using a power of 40 watt, 4 puncture was done in each ovary with
      putting into consideration that the puncture must be not superficial and it must go deep
      through the main substance of the ovary.

      Cooling of the ovary by lactated ringer's solution, finally removal of all instruments under
      vision after exclusion of any complication .
    

Detailed description: 
      Pneumoperitoneum is done by insertion of the verress needle at the inferior edge of the
      umbilicus putting into consideration the following tests:

        1. Needle test: Verress needle patency check.

        2. Hissing phenomenon: Needle introduced by open valve mechanism.

        3. Aspiration test: Placing a drop of water on the opening of the needle and examine its
           disappearance into the abdomen.

        4. Volume test: Changes occurred in the intra abdominal pressure during gas insufflations.

      Intra abdominal pressure 12-16 mmHg usually suitable for this pelvic surgery. Introduction of
      the laparoscopic instruments all in its place

        -  Laparoscopic telescope : From the inferior edge of umbilicus through trocar and sleeve
           which inserted by corkscrew technique then removed to allow the telescope insertion
           which connected to light source , camera head and color monitor.

        -  2nd and 3rd punctures were done allowing another two graspers to be inserted usually at
           a point represent outer 1/3 of the lateral abdominal wall in an imaginary line from
           umbilicus to iliac bone.

      Puncturing technique :

      Fixation of one ovary away from intestine by grasping the ovarian ligament with the traumatic
      grasper which allow good exposure of the ovary and allow drilling .

      Drilling needle was introduced and connected by monopolar current, held against ovarian
      surface for 4 seconds using a power of 40 watt, 4 puncture was done in each ovary with
      putting into consideration that the puncture must be not superficial and it must go deep
      through the main substance of the ovary.

      Cooling of the ovary by lactated ringer's solution, finally removal of all instruments under
      vision after exclusion of any complication .
    

Intervention name(s): Laparoscopic ovarian drilling
Intervention type(s): Procedure
Intervention description(s): Drilling needle was introduced and connected by monopolar current, held against ovarian surface for 4 seconds using a power of 40 watt, 4 puncture was done in each ovary with putting into consideration that the puncture must be not superficial and it must go deep through the main substance of the ovary
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment