Volume: 7 Issue: 3
Year: 2019, Page: 51-56,
Background: Laparoscopy has become an accepted and standard approach in the management of adnexal masses.
Material and Methods: We performed a retrospective record based cross sectional study over a 4 year reriod of 90 cases of adnexal masses which were managed laparoscopically. Aim of the study: To evaluate the safety and effectiveness of laparoscopy in management of adnexal masses.
Results: In 88 cases, procedure was completed safely with minimum morbidity. In 2 cases laparotomy was done to complete the procedure. In 48 cases cystectomy was done, 15 cases required oophorectomy, 10 required salpingo oophorectomy and 9 required salpingectomy. Histologic evaluation revealed 46 functional cysts, 6 endometriotic cysts, 6 dermoid cysts, 9 serous cystadenomas, 3 mucinous cystadenomas, 10 paraovarian cysts, 2 cases of hydrosalpinx and 7 cases of ectopic pregnancy.
Conclusion: Adnexal masses thought to be benign pre operatively were successfully managed laparoscopically. Laparoscopy helped to reduce post operative morbidity, hospital stay, blood loss, cost and adhesion formation thus improving quality of life.
Keywords: Laparoscopy, Adnexal mass
1. SemmK, Mettle L. Technical progress in pelvic surgery via operative laparoscopy. American journal of obstetrics and gynecology. 1980 Sep-15;138(2):121-7.
2. Medeiros L, Rosa DD, Bozzetti MC, Fachel JM, Furness S, Garry R, Rosa ML, Stein AT. Laparoscopy versus laparotomy for benign ovarian tumour. The Cochrane Library. 2005 Jan 1.
3. Pados G, TSOLAKIDIS D, Bontis J. Laparoscopic management of the adnexal mass. Annals of the New York Academy of sciences. 2006 Dec 1;1092(1):211-28.
4. Deckardt R, Saks M, Graeff H. Comparison of minimally invasive surgery and laparotomy in the treatment of adnexal masses. The journal of the American Association of gynecologicLaparoscopists. 1994 Aug 31;1(4):333-8.
5. Herrmann U, Locher G,Goldhirsch A.Sonographic patterns of malignancy: prediction of malignancy.ObstetGynecol 1987;69:771.
6. Jacobs I,Bast R,The CA-125 tumor associated antigen: a review of the literature. Hum Reprod 1989;4:1.
7. Nezhat F, Nezhat C, Welander CE. Four ovarian cancer diagnosed during laparoscopic management of 1,011 adnexal masses.
8. Hulka JF,Parker WH,Surrey M. Management of ovarian masses: AAGL 1990 Survey. J Repodmed 1992;37:599.
9. Grimes DA, Jones LB, Lopez LM, Schulz KF. Oral contraceptives for functional ovarian cysts. Cochrane Database cyst Rev 2006; CD006134.
10. Spanos WJ pre operative hormonal therapy of cystic adnexal masses. Am J. ObstetGynecol 1973; 116:551.
11. Functional ovarian cysts and oral contraceptives.Negative association confirmed surgically.Acooperative study ,JAMA1974;228:68.
12. Caillouette JC, Koehler AL. Phasic contraceptive pills and functional ovarian cysts.Am J. ObstetGynecol 1987; 156:1538.
13. Holt VL,Daling JR,Mc knight B,et.al.Functional ovarian cysts in relation to the use of monophasic and triphasic oral contraceptives.ObstetGynecol 1992;79:529.
14. Mishell DR Jr.Non contraceptive benefits of oral contraceptives.J Reprod Med 1993; 38:1021.
15. Grimes DA, Godwin AJ, Rubin A, et.al. Ovulation and follicular development associated with three low dose oral contraceptives: a randomized controlled trial.ObstetGynecol 1994; 83:29.
16. Egarter C,Putz M,Strohmer H,et.al. Ovarian function during low dose oral contraceptive use. Contraception 1995; 51:329.
17. Holt VL,Cushing,HaugenKL,DalingJR.OralContraceptives,tubal sterilization and functional ovarian cyst risk.ObstetGynecol 2003; 102:252.
18. American college of obstetricians and Gynecologistscommitte on Gynenologic practice. Committe opinion No.477: the role of obstetrician.Gynecologist in the early detection of epithetial ovarian cancer. ObstetGynecol 2011; 117:742.
19. Donnez J, Nisolle M, Smoes P. Peritoneal endometriosis and endometriotic nodules of the rectovaginal Septum are two different entities. FertilSteril 1996; 66:362.8.
20. VercelliniP,VendolaN,BoccioloneL.Reliability of the visual diagnosis of ovarian endometriosis.FertilSteril 1991; 56:1198.
21. Hasson HM. Laparoscopic management of ovarian cysts.J Reprod Med 1990; 25:863.
Siripurapu S, Vivekananda A, Mythreai et al. Laparoscopic Management of Adnexal Masses in the Reproductive Age Group . Perspectives in Medical Research 2019; 7(3): 51-56