Laparoscopic oophorectomy.

Laparoscopic oophorectomy is one of the most controversial and challenging areas of endoscopic surgery. Judicious preoperative evaluation along with careful patient selection can reduce the risk of operating on an unsuspected ovarian malignancy. Appropriate patient consent and planning should be obtained before the procedure, in case an ovarian neoplasia should be encountered. Although endoscopic pelvic biopsy, treatment and staging has been reported recently, the standard of care still appears to be by a laparoscopy. The removal of benign cystic teratomas of all sizes can be handled laparoscopically with the assistance of a retrieval bag or pouch. Reports of endoscopic treatment of ovarian remnant syndrome, androgen insensitivity syndrome, and even prophylactic oophorectomy are appearing in the literature. They have major benefits to patients including reduced cost, decreased hospitalization and time away from work, and with similar or lower complication rates compared with other modes of treatment. Pelviscopy or operative laparoscopy is gaining in popularity and acceptance as our experience and training improves.