Laparoscopic Gynecological Surgery


	UM Guidelines

Laparoscopic Gynecological Surgery, Including Myomectomy, Oophorectomy, and Salpingectomy

Inpatient and Surgical Care (ISC) ORG: S-775

BCBST modification effective September 27, 2007*

Deleted:

There were no deletions.

Added to: Clinical Indications

Bilaterial oophorectomy for presence of hormone receptor-positive operable breast cancer with ALL of the following:

Premenopausal

Completion of childbearing

Sources

Prowell TM, Davidson NE (2004). What is the role of ovarian ablation in the management of primary and metastatic breast cancer today? The Oncologist, 9, 507-517. Retrieved June 14, 2005 from http://theoncologist.alphamedpress.org/cgi/content/full/9/5/507.

Price K (2004, January). International Breast Cancer Study Group Scientific Summary 2004. International Breast Cancer Study Group, p. 24. Retrieved June 14, 2005 from http://www.ibcsg.org/public/documents/pdf/divers/Sci_Summ_2004A4.pdf.

Ochs L, et al. (2004, September). Institute for Clinical Systems Improvement. Health Care Guideline: Breast Cancer Treatment, Retrieved June 14, 2005 from http://www.icsi.org/knowledge/detail.asp?catID=29&itemID=154.

National Cancer Institute. (2005, May). Breast cancer treatment. Retrieved June 15, 2005 from http://www.nci.nih.gov/cancertopics/pdq/treatment/breast/healthprofessional/allpages/print#Section_260.

American College of Obstetricians and Gynecologist. (1999). ACOG Practice Bulletin: Prophylactic oophorectomy. Retrieved May 3, 2006 from http://www.acog.org/publications/pdfs/pb007.pdf

* These guideline(s) have been revised from the Milliman USA Milliman Care Guidelines. The portions of the guideline(s) which have been revised are identified through the use of [insert: italic, boldface, underlined, etc. as appropriate] text, and Milliman USA has neither reviewed nor approved the modified material. Any statement to the contrary or association of the modified material with Milliman USA is strictly prohibited. This document has been classified as public information.

The above information only contains the modified portion of the Milliman Care Guideline. If you wish to view the complete Milliman Care Guideline, please contact Milliman USA.

	Added to: Clinical Indications


	Bilaterial oophorectomy for presence of hormone receptor-positive operable breast cancer with ALL of the following: Premenopausal Completion of childbearing Sources Prowell TM, Davidson NE (2004). What is the role of ovarian ablation in the management of primary and metastatic breast cancer today? The Oncologist, 9, 507-517. Retrieved June 14, 2005 from http://theoncologist.alphamedpress.org/cgi/content/full/9/5/507. Price K (2004, January). International Breast Cancer Study Group Scientific Summary 2004. International Breast Cancer Study Group, p. 24. Retrieved June 14, 2005 from http://www.ibcsg.org/public/documents/pdf/divers/Sci_Summ_2004A4.pdf. Ochs L, et al. (2004, September). Institute for Clinical Systems Improvement. Health Care Guideline: Breast Cancer Treatment, Retrieved June 14, 2005 from http://www.icsi.org/knowledge/detail.asp?catID=29&itemID=154. National Cancer Institute. (2005, May). Breast cancer treatment. Retrieved June 15, 2005 from http://www.nci.nih.gov/cancertopics/pdq/treatment/breast/healthprofessional/allpages/print#Section_260. American College of Obstetricians and Gynecologist. (1999). ACOG Practice Bulletin: Prophylactic oophorectomy. Retrieved May 3, 2006 from http://www.acog.org/publications/pdfs/pb007.pdf