Percutaneous-assisted laparoscopic bilateral salpingo-oophorectomy in BRCA-mutated patients: a retrospective comparative study

Objectives: Prophylactic salpingo-oophorectomy in BRCAmutated patients reduces the risk of breast and ovarian cancer. This study aimed to compare peri-operative outcomes of BRCA-mutated patients who underwent prophylactic salpingo-oophorectomy via traditional laparoscopy or percutaneous assisted laparoscopy. Methods: In this single-center retrospective cohort study, BRCA-mutated patients submitted to laparoscopic prophylactic bilateral salpingo-oophorectomy were enrolled. We compared traditional laparoscopy and percutaneousassisted laparoscopy, which was performed using the Percuvance grasp. Results: We enrolled 59 patients submitted to prophylactic salpingo-oophorectomy from September 2017 to September 2022. Thirty-nine underwent a conventional laparoscopic procedure (LPS) and 20 a percutaneous-assisted laparoscopy (PERC). Similar clinical characteristics were found in the two groups, furthermore, no differences were noticed in terms of peri-operative complication, intraoperative blood loss (p=0.7), and hospital stay (p=0.6). A significantly lower postoperative pain, using VAS score, was noticed in the PERC group compared with the LPS group, on both the first and second days after surgery. Moreover, better cosmetic results have been highlighted in the PERC group. Conclusions: Percutaneous-assisted laparoscopy seems an effective and safe procedure for laparoscopic prophylactic adnexectomy in BRCA-mutated patients. Furthermore, the percutaneous procedure showed better aesthetic outcomes and reduced post-operative pain, compared to traditional laparoscopy.