Laparoscopy for adnexal masses in the second trimester of pregnancy.
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.
Stepp
Kevin J
KJ
Department of Gynecology, Cleveland Clinic Foundation, A81, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Tulikangas
Paul K
PK
Goldberg
Jeffrey M
JM
Attaran
Marjan
M
Falcone
Tommaso
T
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