Opportunistic Salpingectomy at the Time of Cesarean Delivery
Bibliographic record
Abstract
BACKGROUND: High-grade serous ovarian cancer is the most common and lethal form of ovarian cancer, responsible for up to 80% of ovarian cancer-related deaths. Current screening methods are ineffective, and most patients present with advanced disease. Evidence shows that many cases originate in the distal fallopian tube rather than the ovary itself, prompting adoption of opportunistic salpingectomy during gynecologic surgery to reduce ovarian cancer risk. Cesarean delivery, one of the most commonly performed surgeries globally, provides a valuable opportunity to offer salpingectomy to patients already undergoing abdominal surgery, reducing future ovarian cancer risk without an additional procedure. TECHNIQUE: After fetal delivery and uterine closure, the uterus is exteriorized to improve access. The fallopian tubes are gently compressed to relieve vascular congestion and elevated with atraumatic graspers, then windows are created within the avascular spaces of the mesosalpinx using monopolar electrocautery. Skeletonized vessels are coagulated and transected, and the remaining pedicles are clamped, transected, and suture ligated. Complete removal of both tubes, including the fimbriae, is performed. Specimens are sent to pathology, and the cesarean closure proceeds in the usual fashion. EXPERIENCE: At our institution, opportunistic salpingectomy is offered to patients undergoing cesarean delivery who have completed childbearing. Prenatal counseling addresses the procedure's benefits, risks, and permanent nature. In our experience, it adds 7-10 minutes of operative time without increasing blood loss, infection, or hospital stay. CONCLUSION: Opportunistic salpingectomy at cesarean delivery is a safe and feasible evidence-based strategy to reduce ovarian cancer risk. With appropriate technique, counseling, and patient selection, opportunistic salpingectomy at cesarean delivery provides a valuable risk-reduction opportunity during an already indicated procedure.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".