At the time of total hysterectomy, discuss the pros and cons of removing the fallopian tubes in patients who are at risk for ovarian cancer and wish to preserve their ovaries. For women who wish to be sterilized laparoscopically, the physician should bring up the fact that double oophorectomy is a very effective method of sterilization. Prophylactic oophorectomy may provide a means of preventing ovarian cancer in patients. Randomized controlled studies are needed to confirm the validity of tubal resection for the prevention of ovarian cancer. Ovarian cancer is the 5th most deadly cancer in women, with little overall survival progress over the past 50 years. Invasive epithelial ovarian cancer represents 75% of ovarian cancers and causes 90% of ovarian cancer-related deaths. There is still no reliable and effective screening protocol for ovarian cancer. Recent theories suggest that plasmacytic, endometrioid, and clear cell-like ovarian cancers originate in the fallopian tubes and endometrium rather than directly in the ovary. In women with a genetic predisposition to ovarian cancer, lesions extremely similar to high-grade plasmacytoma of the ovary or plasmacytoma of the intraepithelial lining of the oviduct are found in their fallopian tubes. These carcinomas are considered to be the source of ovarian cancer. Oviductal lesions expressing TP53 variants resemble high-grade plasmacytoma, high-grade endometrioid carcinoma, and undifferentiated carcinoma. Also, gene expression in high-grade plasmacytoma is highly correlated with oviduct morphology rather than with ovarian epithelium. High-grade plasmacytoma expresses the Mullerian duct marker (PAX8) but not the mesothelial marker (calretinin). Previous studies have found a protective effect of oviduct ligation in endometrioid and clear cell carcinomas. Removal of the fallopian tubes at the time of total hysterectomy or removal of the fallopian tubes as a method of sterilization are safe and do not increase the risk of comorbidities (compared to total hysterectomy and oviduct ligation). Ovarian function is also not affected by them. Double adnexal resection will result in surgical menopause, osteoporosis and cognitive impairment. In the Nurses’s HealthStudy study, women who underwent bilateral adnexal resection (BSO) had increased all-cause mortality and cancer-related mortality. The risk of ovarian cancer after total hysterectomy with preserved ovaries was 0.1-0.75 percent. In the Nurses’s HealthStudy study, the rate of death from ovarian cancer after adnexal preservation was only 0.03%. However, the protective effect of preserving the ovaries decreases with age, and is virtually absent after age 65. Clearly, double oophorectomy is a better option than BSO resection. There is no clear evidence on the need to remove all the oviducts. Therefore, for younger women, postpartum partial oophorectomy or intermediate (interval) partial oophorectomy may be considered, both of which have been shown to have cumulative pregnancy rates of 7.5 and 20.1/1000 operations, respectively, in studies. In addition, physicians should remind patients that oophorectomy is an irreversible means of sterilization. Total tubal resection is preferable to cystectomy. If oophorectomy is difficult to perform, remove as much of the oviduct as possible, including the interstitial portion. In patients with BRCA mutations, early oviductal lesions are found postoperatively in 1-5%, the vast majority being located at the umbilical end. Earlier benign lesions (plasmacytotic oviductal intraepithelial lesions and migratory oviductal intraepithelial lesions) and the concept of the so-called surrogateprecursor (surrogate precursor), referred to as secretorycelloutgrowth, are implicated in oviductal dysplasia and oviductal carcinogenesis. Plasmacytotic oviductal intraepithelial neoplasia and migratory zone oviductal intraepithelial lesions are most commonly found at the umbilical end, whereas secretory cell outgrowth is distributed throughout the oviduct. In low-risk women, removal of the oviduct should be followed by examination of the entire oviduct, especially the umbilical end, for suspicious lesions. The oophorectomy should begin at the union of the uterine oviducts, and the interstitial part does not necessarily need to be removed. The portion of the umbilical end that is attached to the ovary must be electrocautery or excised. In addition, care must be taken to avoid disrupting the ovarian blood supply during surgery and the ovarian-tubal ligament should be preserved. Practice has shown that extension oophorectomy is successful. Surveys show that 54% of physicians remove the oviduct at the time of total hysterectomy and 7.2% will use it as a means of sterilization. Moreover, oophorectomy does not increase operative time or comorbidities. However, physicians should still follow the principle of minimal invasiveness until firm evidence is available. It does not change the negative procedure to laparoscopic because of prophylactic oophorectomy, nor should hysteroscopic sterilization operations be abandoned because of sterilization, etc.