Laparoscopic Ovarian Surgery and Adhesions

In: Pelvic Surgery · 1997 · pp. 136–143 · doi:10.1007/978-1-4612-1864-7_13 · W163436635
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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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Abstract

Laparoscopic ovarian cystectomy is becoming the gold standard in the treatment of benign ovarian cyst.1 Although difficulties may be encountered, and the ovaries are generally left open, the effectiveness of this procedure and postoperative adhesion formation have rarely been studied. The ovarian nonclosure that is used by most authors2,3 is highly controversial because microsurgery was developed before laparoscopic surgery, and surgical procedures that involve the ovarian cortex frequently results in periovarian adhesions and associated infertility.4,5 Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

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