Management of adnexal torsion by laparoscopic approach

The study aimed to evaluate the effectiveness and safety of laparoscopic management of adnexal torsion. Early minimal invasive surgical management of adnexal torsion with the main emphasis on an organ-preserving procedure can safely be recommended. Although the incidence of adnexal torsions has increased, the morbidity rate has declined due to safer diagnostics and operative strategies. This is a retrospective case-control study (Canadian Task Force classification II-3) of 33 cases of adnexal torsion over an 11-year period (December 1999-September 2010) in a gynecologic endoscopy unit of a university hospital. Interventions include early diagnostic laparoscopy and utmost protection of the surrounding tissue. Thirty-three cases of laparoscopically managed adnexal torsions were analyzed. Fifty-two percent had conservative organ-sparing procedures, while 48 % underwent resection of ovary, tube, or both. The mean operating time was 69.2 min. There were no complications or conversions to laparotomy. The most common predisposing factor was an adnexal mass with symptoms of pain. Torsion on the right tube is more common than on the left. Laparoscopic surgery is an effective, safe, and feasible method in the diagnosis and treatment of adnexal torsion.