Leonidas Magarakis: Tube removal in laparoscopic sterilization is a safe method
Ovarian cancer often originates in the fallopian tubes. Removing them could reduce the risk of future ovarian cancer. Leonidas Magarakis's thesis shows that removing the fallopian tubes during laparoscopic sterilization does not increase the risk of complications compared to the older method of occlusion.
LEONIDAS MAGARAKIS
Dissertation defense: 24 October 2025 (click for details)
Doctoral thesis: Safety of opportunistic salpingectomy for ovarian cancer prevention at laparoscopic sterilization
Research area: Obstetrics and Gynecology
Sahlgrenska Academy, The Institute of Clinical Sciences
Ovarian cancer is a disease with high mortality. Research has shown that the cancer often begins in the fallopian tubes. Women who had their fallopian tubes removed for other medical reasons also seem to have a lower risk of developing the disease.
This has led to the idea that the fallopian tubes could be removed for preventive purposes, for example during sterilization. The procedure is called opportunistic salpingectomy.
“The problem has been that there has not been sufficient evidence that this preventive method is entirely safe, either in terms of the risk of complications or ovarian function. My thesis therefore investigates this in laparoscopic sterilization, where removal of the fallopian tubes was compared with the classic method of tying them off,” says Leonidas Magarakis, obstetrician and gynecologist specializing in minimally invasive gynecologic surgery, and doctoral student at The Institute of Clinical Sciences.
Background to the SALSTER study
The research group began by reviewing previous studies on how effective removal of the fallopian tubes might be in reducing the risk of ovarian cancer and whether safety had been investigated.
Because the scientific evidence was weak, the national SALSTER study (SALpingectomy at STERilization) was designed and launched.
The study compared the risk of complications from salpingectomy for sterilization performed laparoscopically with the classic method where the fallopian tubes are tied.
No increased risk of complications
Within SALSTER, a substudy was also designed to assess the hormonal safety of the ovaries. Levels of the anti-Müllerian hormone (AMH), which is used to measure ovarian function, were analyzed before surgery and one year later, and the change was compared between groups.
“The most important finding is that removal of the fallopian tubes during laparoscopic sterilization showed no increased risk of complications compared with the classic method. The results suggest that both methods are just as safe from a surgical perspective.”
Inspiring collaboration – time limited
What has been most rewarding about your doctoral project?
“The most rewarding part has been working on such a large and well-conducted study that can contribute new knowledge of direct clinical relevance. Being part of the development and implementation of SALSTER in national collaboration has been both inspiring and fun, especially working with colleagues around the country. I have also appreciated collaborating with many different people and, step by step, learning how research is conducted and building that competence,” says Leonidas Magarakis.
And the most challenging?
“The hardest part has been the challenges that research work always entails. It requires a lot of time and perseverance and often means having to set other things aside. Unfortunately, time is always a limiting factor.”
Text: Jakob Lundberg