Laparoscopic Ovarian Surgery and Adhesions
Laparoscopic ovarian cystectomy's effectiveness and postoperative adhesion formation, particularly with ovarian nonclosure, remain understudied despite controversy and potential infertility risks.
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This chapter discusses laparoscopic ovarian cystectomy for benign ovarian cysts, focusing on technical issues related to leaving the ovary “open” (nonclosure) and the effectiveness of ovarian surgery in relation to postoperative periovarian adhesion formation. It synthesizes evidence that ovarian cortex–involving procedures can lead to periovarian adhesions and associated infertility, noting that ovarian nonclosure is controversial because microsurgery concepts predate laparoscopy and data on adhesion formation after laparoscopic cystectomy are described as rare. The authors highlight that outcomes and adhesion formation have been studied with various laparoscopic techniques and in animal models, but the chapter provides a broad, literature-based overview rather than a single new study. Relevance to endometriosis: the references and discussion explicitly cite laparoscopic management of endometriomas and second-look laparoscopy after laparoscopic cystectomy of large ovarian endometriomas, though the chapter’s main focus is laparoscopic ovarian surgery and adhesions.
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Cites (4)
- Conservative laparoscopic excision of endometriosis by sharp dissection: life table analysis of reoperation and persistent or recurrent disease 1991
- Treatment of endometriosis with an antigonadotropin, Danazol. A laparoscopic and histologic evaluation. 1975
- Laser laparoscopic management of large endometriomas 1991
- Laser laparoscopic management of large endometriomas 1992
References (25)
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