The Laparoscopic Management of Adnexal Masses and Ovarian Cancer

The potential of laparoscopic approach for management of various benign gynecologic problems is well recognized. This chapter highlights the role and risks of laparoscopy in treatment of adnexal masses and ovarian cancer. The laparoscopic approach offers several distinct advantages over laparotomy that includes magnified pelvic and abdominal anatomy allowing precise diagnosis, and improved identification of subtle changes representing metastatic disease. Additional benefits of laparoscopy in gynecologic oncology include: lower morbidity, improved post-operative recovery, and reduced cost. Numerous procedures in gynecologic oncology can be accomplished by endoscopic approach. It is also used in management of benign or suspicious adnexal masses in pre and postmenopausal women, staging of early ovarian cancer, and staging of selected cases of advanced cancer of the ovary. Formal training program within the subspecialty of gynecologic oncology is needed to establish and propagate skills necessary to perform advanced laparoscopic surgery. The competency of a larger number of gynecologic oncologists in operative laparoscopy can thus facilitate organization of large, prospective trials, needed to objectively assess the utility and safety endoscopic procedures.