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OBJECTIVE: We present an educational technique for the safe completion of complete cytoreduction of diaphragmatic disease for the management of advanced ovarian malignancy. METHODS: We demonstrated these steps with attention to anatomical landmarks and surgical approaches, considering intraoperative and postoperative morbidity and mortality. RESULTS: We present the case of a 49-year-old female patient diagnosed with suspected stage 3C ovarian malignancy following diagnostic laparoscopy. We demonstrate the surgical application of the Pringle manoeuvre, type 3 liver mobilisation, and full-thickness diaphragmatic resection. This was completed with a primary closure technique, with integrity ensured through the performance of an air test and Valsalva manoeuvre. Final histology confirmed a serous borderline tumour with invasive implants within a port site nodule (stage 4A). CONCLUSION: This technique affirms the essential skills in gynaecological oncology training and details a challenging case requiring advanced surgical skills and knowledge, with specific consideration for intraoperative multidisciplinary decision-making.

Original publication

DOI

10.5468/ogs.23029

Type

Journal article

Journal

Obstet Gynecol Sci

Publication Date

09/2023

Volume

66

Pages

459 - 461

Keywords

Cytoreduction, Diaphragmatic resection, Liver mobilisation, Peritonectomy, Pringle manoeuvre