title: Laparoscopic management of ovarian remnant.
abstract: OBJECTIVE
  To report outcomes of laparoscopic management of patients with ovarian remnant (OR).
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Referral practice and tertiary medical center.
  
  
  METHODS
  Sixty-four patients with confirmed OR who underwent laparoscopic treatment between July 1989 and September 2003.
  
  
  METHODS
  Laparoscopic excision of OR.
  
  
  METHODS
  Technical feasibility and recurrence.
  
  
  RESULTS
  Sixty-nine laparoscopies were performed to remove ovarian remnants, with five patients requiring two laparoscopies. Two cases were converted to laparotomy and one to mini-laparotomy for bowel resection. In 64% (41 out of 64), pelvic mass was diagnosed by imaging (35 by ultrasound, 5 by computerized tomography [CT], and 1 by both). The majority of ovarian remnants were found attached to one or more of the following: ureter, bowel, pelvic sidewall, bladder, rectum, and uterosacral ligament. Intraoperative complications occurred in four cases: three enterotomy and repair; one cystotomy and repair. Twelve minor postoperative complications occurred including urinary tract infection, hematuria, umbilical incision infection, and transient tachycardia. Three major postoperative complications occurred: one umbilical omental hernia, one wound abscess requiring operation, and one vesicovaginal fistula. Adhesions were present in all cases, endometriosis in 55% (35 out of 64), and fibrosis in 30% (19 out of 64).
  
  
  CONCLUSIONS
  In experienced hands, laparoscopic treatment of OR results in acceptable outcomes with its associated advantages over laparotomy.
authors.affiliation: Center for Special Pelvic Surgery, 5555 Peachtree Dunwoody Road, Suite 276, Atlanta, GA 30342, USA. info@Nezhat.com
authors.forename: Ceana
authors.initials: C
authors.lastname: Nezhat
authors.forename: Susan
authors.initials: S
authors.lastname: Kearney
authors.forename: Shazia
authors.initials: S
authors.lastname: Malik
authors.forename: Camran
authors.initials: C
authors.lastname: Nezhat
authors.forename: Farr
authors.initials: F
authors.lastname: Nezhat
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010049:Ovarian Diseases / Q000601:surgery*; D010052:Ovariectomy / Q000009:adverse effects*; D010053:Ovary / Q000601:surgery*; D017699:Pelvic Pain / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome