Category H: Poster Presentations: Health in Mid‐Life and Beyond (including Menopause/ Vulval Disease)

Abstract

Introduction Laparoscopy is as safe and effective as laparotomy for the treatment of ectopic pregnancy, ovarian cysts, dermoid cysts and adnexal torsion. Treatment with laparoscopy results in shorter hospital stay and faster recovery. None of such studies are shown in the literature from Pakistan so the aim is to assess the effectiveness of laparoscopy in the management of adnexal emergencies, over a 4-year period. Methods Patients presenting in the Emergency department of Patel Hospital with suspicion of or diagnosed adnexal pathology from November 2011 till date were evaluated and kept for laparoscopic surgery. A predesigned proforma was completed for each such patient. The observed variables were indication of surgery, haemodynamic status, presence or absence of haemoperitoneum, time from incision till control of bleeding, total duration of surgery and the operative morbidities. The operative morbidities include the amount of blood loss, need for conversion to laparotomy, duration of stay, visceral/vascular injury, and the condition of the patient at 1 week postoperative follow-up. Results The total number of surgeries was 91. Of these, 69 were ectopic pregnancies and 22 were ovarian cyst accidents. Of them 63 were tubal ectopic, three were ruptured ovarian ectopic, two were cornual ectopic, one caesarean scar ectopic, 12 ovarian torsion and ten ruptured ovarian cysts. There was haemoperitoneum in 63 (80%) cases and 55 (70%) of them were haemodynamically unstable. Time taken to achieve haemostasis, on average, was 5.5 minutes in the case of ectopic gestations and 7.5 minutes in the case of ovarian cysts. The mean time taken for the procedure was 70 minutes for ovarian cysts and 55 minutes for ectopic pregnancy. Conclusion Laparoscopy is effective mode of surgery for all sorts of adnexal emergencies.