Safe and cost-effective laparoscopic removal of adnexal masses.
OBJECTIVE
To evaluate laparoscopic removal of adnexal masses using a plastic bag to avoid peritoneal spillage.


METHODS
An observational study.


METHODS
A university-affiliated private hospital.


METHODS
Thirty-one women (mean age 48.7 yrs) with adnexal masses.


METHODS
Laparoscopic removal of adnexal masses ranging from 3 to 12 cm (18 complex, 5 septated cystic masses, 8 persistent simple cysts). The masses were placed in plastic sandwich bag and removed through the umbilical incision. Hospital costs, length of stay and operating times were compared with those of 24 patients undergoing the removal of similar masses by laparotomy.


RESULTS
Three masses were functional cysts, 4 were tubal cysts, 4 were endometriomas, and 20 were benign ovarian neoplasms. There were no malignancies. Peritoneal spillage occurred during one ovarian cystectomy. The only complication was bleeding from the cannula site. Comparing laparoscopy and laparotomy, average operating time was 73.45 minutes (range 34-148 min) and 81 minutes, average length of hospital stay was 17.4 hours (range 6-73 hrs) and 2.92 days, and average hospital cost was $2401 and $3539, respectively.


CONCLUSIONS
Laparoscopic access provides a cost-effective method of removing adnexal masses with a very small risk of peritoneal spillage. When managed in this manner, rather than laparotomy, the cost reduction was significant.
Quinlan
D J
DJ
Department of Obstetrics and Gynecology, Greater Victoria Hospital Society, British Columbia, Canada.
Townsend
D E
DE
Johnson
G H
GH
D000291:Adnexal Diseases / Q000191:economics* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics* / Q000379:methods; D007813:Laparotomy / Q000191:economics* / Q000379:methods; D007902:Length of Stay / Q000191:economics; D008875:Middle Aged; D019370:Observation; D011183:Postoperative Complications; D012307:Risk Factors; D012449:Safety