IPEG 2020 TOP ABSTRACT: Crucial steps in in laparoscopic management of torted paraovarian cysts

Crucial steps in a laparoscopic management of tortid perovarian cysts. Identification of perovarian tumors may be challenging and result in needless dissection and iatrogenic injury to both ovary and tube. Tortid eggnexa may change anatomy of the ovary, tube, and the perivarian cyst. Correct identification of the latter is the key to appropriate management and agnexal preservation during surgery. We prefer the following steps for appropriate management of the torted perivarian cyst. After insertion of the scope, adnexal torsion is confirmed. Distortion of the mass reveals separate localized ovary and the perivarian cyst. The tube overlying the cysts with stretched broad ligament together with identified ovary established the diagnosis of perovarian, not interovarian mass. Broad ligament remotely from the tube is incised. Further dissection is continued with hook electrocautery. After wide opening of the broad ligament, the cyst is inoculated by pulling down maneuver. The cyst is opened and liquid content is evacuated with suction. The specimen, what is thin wall of the cyst, is extracted via 5 millimeter trochar or through the port site.