Objective: Demonstrate the usefulness of using indocyanine green after laparoscopic ovarian detorsion to save the ovary. Design: A step-by-step video demonstration of a surgical technique.
INTERVENTIONS: A 17-year-old patient, was referred to our hospital for acute abdominal pain. Ultrasound revealed ovarian torsion; therefore, the patient underwent surgical treatment. During laparoscopy, the presence of a right ovarian torsion was confirmed. A lesion compatible with a hemorrhagic corpus luteum of 6 cm was present on the ovary affected. Before ovarian detorsion, indocyanine green was administered intravenously at a 0.5mg/kg dose. The first aspect noted was the total lack of ovarian vascularization, then ovarian detorsion was performed. At this point, using technology of Rubina®(KARL STORZ SE&Co.KG, Germany), it was possible to highlight the progressive ovarian revascularization. Ovarian reperfusion occurred starting from the ovarian hilum and ending at the periphery. We proceeded with enucleation of the hemorrhagic corpus luteum by stripping technique, with subsequent ovarian reconstruction with continuous 2-0 monofilament suture. Finally, we fixed the ovary to the stump of the right round ligament. The final view highlights good ovarian vascularization. No complications occurred; the patient was discharged on the 1st postoperative day. A six-month follow-up ultrasound confirmed the recovery of the vascularization of ovary