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Chapter-10 Laparoscopic Management of Adnexal Masses

BOOK TITLE: State of the Art Atlas of Endoscopic Surgery in Infertility and Gynecology

Author
1. Nezhat Farr R
2. Nezhat Ceana H
3. Nezhat Camran
ISBN
9788184489903
DOI
10.5005/jp/books/11190_10
Edition
2/e
Publishing Year
2010
Pages
12
Author Affiliations
1. The Mount Sinai Medical Center, 5 East 98th Street, Box 1173 New York, NY, e-mail:farr.nezhat@mssm.edu, 1000 Tenth Ave Ste 10-C New York, NY 10019 USA, Division of Gynecologic Oncology, Mount Sinai School of Medicine, 1 Gustave L Levy Place, New York NY 0029, USA, St. Luke’s and Roosevelt Hospitals, Academic Affiliates of Columbia University, College of Physicians and Surgeons, New York, NY, USA, School of Medicine at Mount Sinai; Mount Sinai St Luke’s and Mount Sinai Roosevelt Hospitals, New York; State University of New York at Stony Brook, School of Medicine; Winthrop University Hospital, Mineola, New York, USA
2. Peachtree Dunwoody Rd NE Ste 276, Atlanta GA 30342-1726, USA
3. Stanford University, USA, Stanford University Hospital, Palo Alto, California, USA, Stanford Endoscopy Centre for Training and Training and Technology; Stanford University School of Medicine Stanford, California, Centre for Special Minimally Invasive and Robotic Surgery, 900 Welch Road, Suite 403 Palo Alto, CA 94303
Chapter keywords

Abstract

Laparoscopic management of adnexal masses has become the most commonly performed minimally invasive procedure in gynecology. This approach offers multiple benefits including smaller incisions, shorter hospital stays, less need for postoperative analgesics, improved visualization, less adhesion formation and lower blood loss. The main concern is distinguishing benign and malignant processes both preoperatively and intraoperatively. Laparoscopic evaluation of masses determined to be equivocal on preoperative assessment can prevent many laparotomies for benign masses. The incidence of ovarian carcinoma during laparoscopy for adnexal masses ranges from 0.4 to 15%. The lifetime risk for ovarian cancer is 1 in 70 women. Surgical intervention for an adnexal mass should be considered in postmenopausal women or if persistent in reproductive age women.

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