LAPAROSCOPIC ADNEXECTOMY - A COMPARISON WITH LAPAROTOMY

OBJECTIVE: Our purpose was to compare the newer technique of laparosco pic adnexal excision with conventional laparotomy. DESIGN: With the sa me entry criteria, a retrospective, consecutive series of 26 women who underwent adnexectomy by laparotomy was compared with a later prospec tive consecutive series of 64 women who had laparoscopic adnexectomy i n a university referral practice. The two groups were similar in all c haracteristics examined. The ages of the women ranged from 18 to 70 ye ars, but only two women were postmenopausal. Pelvic pain with or witho ut an ovarian cystic mass was the surgical indication in 98% to 92% of the women. Seven women had a persistent adnexal cystic mass and one w oman had a unilateral androgen-secreting ovary. Bipolar coagulation wa s the laparoscopic method used. RESULTS: Median operating time (88 vs 107 minutes), blood loss (72 vs 222 ml), days in the hospital (1 day v s 3 days), total costs ($4573 vs $6044), and recovery time (1 week vs 4 weeks) were significantly less with laparoscopic adnexectomy. There were no differences between the two techniques in major complications (one in each group), blood transfusions, adhesion formation, or the pr oportion of women noting improvement of pain symptoms. CONCLUSION: In this preliminary assessment of laparoscopic adnexectomy, this surgical procedure offers significant advantages to laparotomy in selected pat ients when performed by a laparoscopist experienced in advanced techni ques.