Laparoscopic detorsion allows sparing of the twisted ischemic adnexa

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Abstract

Study Objective. To determine the safety and outcome of laparoscopic detorsion in the management of the twisted ischemic, hemorrhagic adnexa. Design. Retrospective chart review and prospective follow-up (Canadian Task Force classification 11-2). Setting. University-affiliated hospital. Patients. Fifty-eight women with twisted black-bluish ischemic adnexa encountered at laparoscopy. Intervention. Laparoscopic detorsion with adnexal sparing. Measurements and Main Results. All patients had a benign immediate postoperative course. Transient temperature elevation occurred in seven women (12.1%). No signs of pelvic or systemic thromboembolism were detected in any patient. Long-term follow-up included transvaginal ultrasound, which revealed follicular development in the previously twisted adnexa in 54 women; normal macroscopic appearance at incidental subsequent surgery in 9; and in vitro fertilization with retrieval of oocytes from the previously twisted side in 4. Conclusion. Laparoscopic detorsion of the twisted ischemic hemorrhagic adnexa is a safe procedure with minimal postoperative morbidity and a potential for the ovary to recuperate fully with preservation of normal function. Laparoscopic adnexa-sparing procedures should be performed in place of traditional salpingo-oophorectomy in women with this disorder who desire future fertility.

Original languageEnglish
Pages (from-to)139-143
Number of pages5
JournalJournal of the American Association of Gynecologic Laparoscopists
Volume6
Issue number2
DOIs
StatePublished - May 1999
Externally publishedYes

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