Laparoscopic detorsion allows sparing of the twisted ischemic adnexa.
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)
Cohen
S B
SB
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer 52651, Israel.
Oelsner
G
G
Seidman
D S
DS
Admon
D
D
Mashiach
S
S
Goldenberg
M
M
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