title: Laparoscopy for adnexal masses in the second trimester of pregnancy.
abstract: OBJECTIVE
  To assess the safety of laparoscopic treatment of adnexal masses in the second trimester of pregnancy.
  
  
  METHODS
  Retrospective chart review (Canadian Task Force classification II-3.
  
  
  METHODS
  Large tertiary care medical center.
  
  
  METHODS
  Eleven women.
  
  
  METHODS
  Laparoscopic surgery.
  
  
  RESULTS
  All masses were identified by ultrasound. The average gestational age at the time of surgery was 17 weeks, 4 days. In seven women the primary cannula was inserted in the left upper quadrant of the abdomen. Procedures were eight ovarian cystectomies, two oophorectomies, and one exploratory laparoscopy. Average operating time was 135 minutes (range 95-195 min). Average time exposed to carbon dioxide was 78 minutes (range 59-135 min). None of the masses was malignant. There were no fetal complications or malformations. No patients had preterm labor and all delivered at term.
  
  
  CONCLUSIONS
  The increasing number of reported cases and our experience suggest that laparoscopic treatment of adnexal masses in the second trimester is safe and effective, but the surgeon must be skilled in advanced techniques of laparoscopic surgery.
authors.affiliation: Department of Gynecology, Cleveland Clinic Foundation, A81, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Stepp
authors.forename: Paul K
authors.initials: PK
authors.lastname: Tulikangas
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Goldberg
authors.forename: Marjan
authors.initials: M
authors.lastname: Attaran
authors.forename: Tommaso
authors.initials: T
authors.lastname: Falcone
mesh_terms: D000291:Adnexal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D005314:Embryonic and Fetal Development; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal / Q000379:methods