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Aims: The aim of this study was to evaluate the feasibility and efficacy of laparoscopically-assisted staging surgery for ovarian cancer. Methods: Twenty four patients were evaluated. Among them, nineteen underwent initial laparoscopic staging surgery and five patients who were incompletely staged by other institutions underwent complete restaging surgery. The procedure included pelvic lymphadenectomy, paraaortic lymphadenectomy, multiple biopsies, washing cytology, infracolic omentectomy, and appendectomy. Laparoscopically assisted vaginal hysterectomy and bilateral salpingo-oophorectomy were performed on all patients except one. Parameters such as tumor diameter, operating time, estimated blood loss, length of hospital stay, number of harvested lymph nodes, intraoperative and postoperative complications, and recurrence were evaluated. Results: The patients’ mean age was 52.8 ± 11.3 years and the mean parity was 2.5 ± 1.6. The mean diameter of the tumors was 8.4 ± 3.3 cm, the mean operating time was 253.7 ± 65.7 minutes, and the mean blood loss was 567.0 ± 170.9 mL. The mean postoperative hospital stay was 10.6 ± 4.0 days. The mean number of harvested pelvic lymph nodes was 22.5 ± 8.9 and the mean number of harvested paraaortic lymph nodes was 11.0 ± 5.8. None of the operations were switched to laparotomy. There were no major intraoperative complications, however, port site metastasis developed postoperatively in one patient. Conclusion: Comprehensive laparoscopically-assisted staging surgery, performed by a specialized laparoscopic oncologist with sufficient laparoscopic experience and a well-trained operating team, is both feasible and effective in treating ovarian cancers. [ABSTRACT FROM AUTHOR]

Background: Laparoscopy is becoming common for the management of complex benign gynaecological diseases, in which considerable adhesions are expected, thus making the laparoscopic surgery more difficult to perform. Aims: To evaluate the efficacy and safety of laparoscopic surgery for adnexal tumours in post-hysterectomy women. Methods: In a retrospective study, we reviewed and analysed 40 post-hysterectomy women who were treated surgically for benign ovarian tumours at Kangbuk Samsung Hospital, from May 1999 to April 2007. Twenty women received laparotomic surgery and 20 were treated by laparoscopic surgery. Operating time, haemoglobin changes, complication rates, return of bowel activity, and duration of hospital stay were evaluated. Results: Operating time, haemoglobin changes, and complication rates were similar for both groups. For the laparoscopy group, the return of bowel activity was significantly faster (33 vs 45 h; P = 0.0131) and hospital stay was significantly shorter (four vs eight days; P = 0.0005) than for the laparotomy group. Conclusions: Laparoscopic surgery for adnexal tumours in post-hysterectomy women might be an effective and safe alternative to laparotomic surgery. Surgical experience in this procedure and a thorough understanding of retroperitoneal anatomy from a laparoscopic view are mandatory to ensure low morbidity. [ABSTRACT FROM AUTHOR]

Background: Several studies reported that pathology of the appendix is frequently detected alongside endometriosis, especially with chronic pelvic pain. Furthermore, ovarian endometriosis is a marker of more extensive pelvic and intestinal disease. Aims: To evaluate the feasibility and efficacy of incidental appendectomy in laparoscopic surgical treatment for ovarian endometrioma. Methods: One hundred and six women with ovarian endometrioma underwent laparoscopic surgery including laparoscopic appendectomy. Clinicopathological data were collected and analysed. Results: The main symptoms consisted of lower abdominal pain in 51 (48.1%) women, dysmenorrhoea in 23 (21.7%), left lower quadrant pain in 6 (5.7%), right lower quadrant pain in nine (8.5%), chronic pelvic pain in five (4.7%), and others in 12 (11.3%). Only three (3.3%) of the 106 women had abnormal findings on gross inspection during laparoscopic surgery: two women with endometriotic spots on the surface of their appendixes, and one with peri-appendiceal inflammation with severe adhesions. Of the 106 resected appendixes, 37 (34.9%) had histopathologically confirmed pathology including lymphoid hyperplasia in 12 (11.3%), endometriosis in 14 (13.2%), peri-appendicitis and serositis in five (4.7%), carcinoid tumour in three (2.8%), and others in three (2.8%). Conclusions: In all surgical treatments for ovarian endometrioma, surgeons need to preoperatively inform the patients of the fact that appendiceal pathology including endometriosis is found frequently regardless of concurrent symptoms or gross finding of the appendix. Furthermore, surgeons should take into account the possibility of appendiceal pathology during operation. [ABSTRACT FROM AUTHOR]