Opportunistic bilateral salpingectomy is now promoted for women at the time of hysterectomy for benign gynaecological disease. This is the result of the fallopian tube, particularly the fimbral end, emerging as the primary site of carcinogenesis in high grade serous ovarian cancers. In BRCA positive women, BSO offers the greatest risk reduction for ovarian cancer, however, bilateral salpingectomy with delayed oophorectomy may be a more effective strategy in overcoming the quality of life issues associated with oophorectomy in pre-menopausal women.

We known there is no direct connection between the ovary and its adjacent fallopian tube, however we often find intra-operatively remnants of the fimbria adherent to the ovary. We performed a pilot study on 20 women undergoing risk reducing surgery to demonstrate this tubo-ovarian interface exists microscopically and challenge the practice that bilateral salpingectomy alone may not be an effective risk reducing strategy.