Answer to Lady Who Lived in a Shoe

Question: In the image, what specific structure was surgically removed in fulfillment of the request by the lady in the shoe?

Correct answer is D. In Latin, salpinx refers to a trumpet, from the Greek. The term salpingectomy means fallopian tube excision; hence, the lady is requesting a complete tubal removal, not just a ligation. While removal of all the indicated structures will result in permanent sterility, oviduct ligation or removal is the usual procedure performed to achieve sterility if no other organ issue is involved. Fallopian tubes are hollow structures through which eggs travel from the ovaries to the uterus. The term can refer to procedures that remove one or both fallopian tubes entirely, or that take out only parts of the fallopian tube(s). A tubal ligation blocks a section of the fallopian tubes. Both procedures are permanent forms of contraception, however, women undergoing such procedures will continue their menstrual cycles until menopause, albeit their eggs will be absorbed by the body. Further, multiple observational trials confirmed that laparoscopic tubal occlusion reduces the incidence of ovarian cancer (relative risk, 0.29–0.69) . This protective effect persists after adjusting for age, use of oral contraceptives, and parity. Tubal occlusion maintains its protective effect in women at high risk of ovarian cancer due to BRCA1 and BRCA2 mutations. Evidence suggests that ovarian cancer may originate from the fimbriae of the fallopian tube, and complete salpingectomy for tubal sterilization is becoming increasingly common.

1.= Cervix

2.= Uterus

3.= Ovary

4.= Oviduct

5.= Fimbriae

Answer to this question is based on material presented in lectures 3 of the Pelvis Lecture Series.