Laparoscopic management of adnexal masses. Safety and effectiveness.

OBJECTIVE

To evaluate the effectiveness and safety of the laparoscopic approach to adnexal masses.

STUDY

DESIGN

Sixty-one patients who underwent laparoscopic intervention due to various types of adnexal masses between March 1997 and April 1999 in a teaching hospital were assessed retrospectively. Patients with strong evidence of advanced ovarian cancer, such as large masses, ascites or omental cake, were excluded. Frozen section was performed intraoperatively, if indicated. In cases of malignancy, laparotomy was performed.

RESULTS

Mean operation time was 67.2 minutes; average hospital stay was 1.2 days. Cyst enucleation was performed in 34% of patients. Two of 61 patients were diagnosed as having malignant disease and converted to laparotomy. Chemical peritonitis was encountered after dermoid cyst removal due to spillage of contents in spite of using an endobag and irrigating copiously with saline. No other complications were seen.

CONCLUSION

Laparoscopy is a safe approach to adnexal masses and may decrease the rate of unnecessary laparotomies for benign cysts, which give no suspicious ultrasonographic signs.