title: Laparoscopic detorsion allows sparing of the twisted ischemic adnexa.
abstract: OBJECTIVE
  To determine the safety and outcome of laparoscopic detorsion in the management of the twisted ischemic, hemorrhagic adnexa.
  
  
  METHODS
  Retrospective chart review and prospective follow-up (Canadian Task Force classification II-2).
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  Fifty-eight women with twisted black-bluish ischemic adnexa encountered at laparoscopy.
  
  
  METHODS
  Laparoscopic detorsion with adnexal sparing.
  
  
  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.
  
  
  CONCLUSIONS
  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. (J Am Assoc Gynecol Laparosc 6(2):139-143, 1999)
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer 52651, Israel.
authors.forename: S B
authors.initials: SB
authors.lastname: Cohen
authors.forename: G
authors.initials: G
authors.lastname: Oelsner
authors.forename: D S
authors.initials: DS
authors.lastname: Seidman
authors.forename: D
authors.initials: D
authors.lastname: Admon
authors.forename: S
authors.initials: S
authors.lastname: Mashiach
authors.forename: M
authors.initials: M
authors.lastname: Goldenberg
mesh_terms: D000291:Adnexal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D010053:Ovary / Q000098:blood supply*; D012189:Retrospective Studies; D014102:Torsion Abnormality / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography