We appreciate the opportunity to review the manuscript of Morelli et al, which was recently e-published ahead of print in Gynecologic Oncology . Ensuring surgical feasibility and safety is important as we move forward to use strategies of risk reduction. In this single-institution retrospective study, 79 patients who had salpingectomy with their total laparoscopic hysterectomy (TLH) since 2010 were compared with 79 patients who underwent a simple TLH from 2008 to 2010. The authors importantly found no increase in complications with additional salpingectomy and also found that there was no significant change in ovarian reserve 3 months after surgery.

These important data indeed add to a growing body of literature examining the feasibility and consequences of salpingectomy for the anticipated prevention of ovarian cancer. Yet to be determined is whether ovarian function is compromised in the long-term, because an interruption of normal blood supply may lead to chronic changes that would not be seen 3 months postoperatively. We look forward to reports from additional surgeons regarding their outcomes as well, because no clear methodology has been described that optimizes this procedure. In the meantime we agree that a discussion with patients about potential benefits and risks of salpingectomy at the time of hysterectomy should be a part of the informed consent process.