Evaluation of Laparoscopic Approach in the Management and Outcome of Benign Adnexal Masses

Background: Adnexal masses are one of the most common diseases affecting women of all ages. Adnexal masses are frequently accompanied by symptoms such as dyspareunia, bloating, increased abdominal girth, pelvic pain, irregular vaginal bleeding, and abdominal pain. This study assessed the feasibility of laparoscopic management of adnexal masses predicted to be benign. Methods: A cross-sectional study was conducted on 50 women presenting with adnexal masses which were benign at the Department of Obstetrics and Gynaecology, SCB Medical College, Cuttack, Odisha, India. The duration of the study was 12 months. All the women fulfilling the inclusion and exclusion criteria were then taken up for laparoscopic management. Results: Laparoscopy was completed in 49/50 patients (98%) and converted to laparotomy in one case. Most common indication of procedure was ovarian cyst; others were dermoid cyst, endometriotic cyst, hydrosalpinx, and adnexal mass. There were mild adhesions (16%) and dense adhesion (2%). Three patients had intraoperative blood transfusion as they were anaemic preoperatively. Mean duration of surgery ranged from 50 minutes to 100 minutes. Most patients were discharged after 2 days and advised to abstain for 2 months, avoiding heavy work. Histopathological reports correlated with laparoscopic findings. Patients were called for follow-up visit after 6 weeks of surgery or earlier if any problem occurred. None of the patients had any major complaints. Conclusion: Laparoscopy is effective in the management of benign adnexal masses. It helps in reducing hospital stay as well as reducing hospital-acquired infections. It is cost-effective, thus reducing hospital stays and reducing early discharges. It is also cosmetically better than laparotomy. However, selecting cases for laparoscopic management of adnexal mass is important.