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Laparoscopic removal of a large adnexal mass
1Department of Obstetrics and Gynecology, Kaiser Permanente Medical Group, Honolulu, Hawaii, USA. christian.s.sunoo@kp.org
Background:
Laparoscopic removal of adnexal masses has been facilitated by the use of commercially available retrieval bags. Masses up to 18 cm can be removed using zipper storage bags. Masses with greater diameters have required laparotomy or techniques that do not isolate the mass from the peritoneal cavity. By using larger bags available in the operative suite, even the very large adnexal mass can be isolated from the peritoneal cavity and extracted via laparoscopy.
Case:
A 46-year-old nulligravida presented with a 20.9-cm adnexal mass. She underwent laparoscopy and extraction of a dermoid with an improvised retrieval bag without intraperitoneal spillage.
Conclusion:
Very large adnexal masses can be removed laparoscopically without intraperitoneal spillage despite the lack of commercially available bags for this purpose.
