Laparoscopic treatment of premenopausal patients with benign adnexal pathology

Abstract

The aim of this study was to evaluate the laparoscopic approach to benign adnexal masses in 211 premenopausal patients selected with strict preoperative clinical and ultrasound diagnosed criteria. Most patients were successfully managed with operative laparoscopy (98.2%). Four patients underwent laparotomy (1.8%). The rate of unexpected adnexal malignancy was 0.48%. We believe that operative laparoscopy is a safe and effective procedure for treating most benign adnexal masses in premenopausal women. To reduce the possibility of encountering an unexpected malignancy when approaching an adnexal cyst by laparoscopy, appropriate preoperative selection of patient candidates for laparoscopic treatment is mandatory. If an unexpected malignancy arises during laparoscopy, a team with specific oncologic training should be available for a possible immediate staging laparotomy in order not to affect the patient's prognosis.

Large adnexal mass: is laparoscopic surgery a safe option?

“…Similar to the Stamatellos et al study, cyst aspiration was done in reverse Trendelenberg position in large cysts to aid their removal laparoscopically after malignancy had been excluded. 9 There are serious concerns about intraperitoneal spillage and peritoneal seeding. Therefore, a thorough and copious peritoneal lavage was performed immediately after the procedure with irrigation saline.…”