RETROPERITONEAL TECHNIQUE OF LAPAROSCOPIC ADNEXECTOMY AFTER PREVIOUS HYSTERECTOMY FOR PREVENTION OF INTRAOPERATIVE ORGAN RUPTURES

Objective: The possibility of the reduction of organ ruptures during l aparoscopic adnexectomy for cystic adnexal masses after previous hyste rectomy with retroperitoneal techniques was studied. Patients and meth ods: Twenty-five patients with cystic adnexal masses after previous hy sterectomy entered the study. The danger of intraoperative organ ruptu res was diminished by using the retroperitoneal operative technique an d a 'salvage bag' (Endopouch). Results: The laparoscopic operation was successfuly performed in 23 of 25 patients. In 2 patients a laparotom y was performed. The frequency of intraoperative ruptures decreased wi th increasing experience (1992 in 7 of 8; 1995 in 1 of 6 patients). Co nclusion: The frequency of intraoperative organ ruptures during laparo scopic adnexectomy after previous hysterectomy can be significantly de creased by using the retroperitoneal operative technique and the Endop ouch.