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©2013 UpToDate ® Print Email Enlarged left ovary following bivalve procedure with electrocautery Continued arterial perfusion is suggested by the red blood extruding into the cortex along with patches of improved duskiness following this release of the capsular pressure. Reproduced with permission from: Pediatric and Adolescent Gynecology, 6th ed, Emans SJ, Laufer MR, Goldstein DP (Eds), Lippincott Williams & Wilkins, Philadelphia 2012. Copyright © 2012 Lippincott Williams & Wilkins. file://www.lww.com
©2013 UpToDate ® Print Email Enlarged left ovary following bivalve procedure with electrocautery Continued arterial perfusion is suggested by the red blood extruding into the cortex along with patches of improved duskiness following this release of the capsular pressure. Reproduced with permission from: Pediatric and Adolescent Gynecology, 6th ed, Emans SJ, Laufer MR, Goldstein DP (Eds), Lippincott Williams & Wilkins, Philadelphia 2012. Copyright © 2012 Lippincott Williams & Wilkins. file://www.lww.com A second bivalve of this ovary leads to further release of capsular pressure allowing increased arterial perfusion and thus a less dusky appearance This ovarian bivalve procedure demonstrates that the ovarian tissue, despite an initially non-viable appearance, can retain perfused and viable tissues. Bivalving may serve as a valuable intra-operative triage tool to assess viability and avoid unnecessary extirpation of viable ovaries. Reproduced with permission from: Pediatric and Adolescent Gynecology, 6th ed, Emans SJ, Laufer MR, Goldstein DP (Eds), Lippincott Williams & Wilkins, Philadelphia 2012. Copyright © 2012 Lippincott Williams & Wilkins. file://www.lww.com The same ovary seen later in situ with a normal appearance Reproduced with permission from: Pediatric and Adolescent Gynecology, 6th ed, Emans SJ, Laufer MR, Goldstein DP (Eds), Lippincott Williams & Wilkins, Philadelphia 2012. Copyright © 2012 Lippincott Williams & Wilkins. file://www.lww.com