At Pacific Endometriosis and Pelvic Surgery in Gig Harbor, WA, we strive to help our patients understand the steps we take during surgery—not just the “what,” but also the “why.” One procedure you may hear about during your care is an ovarian suspension, often performed at the time of hysterectomy or excision of endometriomas.

What Is an Ovarian Suspension?

An ovarian suspension is a surgical technique in which the ovary is temporarily elevated and stitched higher in the pelvis. This is most commonly done after a hysterectomy to reduce the risk of future complications such as scarring or ovarian torsion. It may also be performed after an ovarian cystectomy for an endometrioma, to prevent the ovary from sticking (adhering) to the pelvic sidewall while the area heals.

You can watch a short video illustrating how a robotic ovarian suspension is performed here: Robotic Ovarian Suspension Video.

Why Is It Done?

When endometriosis is excised, the peritoneum—the thin, almost “saran wrap” layer that overlies the structures in the pelvis—is removed in certain areas. This can leave raw surfaces that may increase the chance of scar tissue forming. In addition, when an endometrioma (an ovarian cyst caused by endometriosis) is excised, the ovary itself has an area of raw edges where the cyst was removed. Those areas are particularly prone to sticking to the peritoneum if the ovary lies directly against it during healing. By temporarily suspending the ovary, we help it heal in a more anterior position, reducing the risk of it becoming “stuck” to the pelvic sidewall.

After a hysterectomy, the suspension also protects against ovarian torsion—a condition where the ovary twists on its blood supply, causing sudden and severe pain. Normally, the uterus and fallopian tubes provide extra stability for the ovaries. Once those structures are removed, the ovary is more mobile and possibly at greater risk of twisting. Therefore, a suspension stitch can help prevent torsion from occurring. 

What Happens to the Stitch?

Most patients receive a dissolvable suture that naturally breaks down within a few weeks. By that time, new peritoneum has formed, and the ovary is less likely to adhere to surrounding tissue.

For patients planning in vitro fertilization (IVF) in the near future, a removable stitch may be used instead (as it is easier for fertility doctors to access the ovary for egg retrieval when it is in its natural location). In this case, the stitch can be taken out four to five days after surgery, allowing the ovary to return to its natural position more quickly while still protecting it during those critical early days of healing.

The Bottom Line

An ovarian suspension may only take a few moments during surgery, but it highlights the difference in approach at Pacific Endometriosis and Pelvic Surgery. While a general gynecologist might not routinely perform this step, we incorporate it because we are always thinking about long-term outcomes and ways to reduce surgical risks. Our goal is to perform one comprehensive surgery that addresses endometriosis thoroughly—so that our patients can avoid repeat operations whenever possible.