[Laparoscopic treatment of ovarian tumors in menopausal women]

The authors report their experiences in the laparoscopical therapy of ovarian tumours with 94 postmenopausal women.

The patients were treated in the Department of Gynecology at Göppingen Medical Center from March 1, 1992 until December 31, 1993. Tumour marker CA 125 was not within normal limits (< 35 U/ml) in all patients. Preoperatively all findings were verified by ultrasound examination. In some cases, cysts were single-chambered, smooth-bounded or without endovegetations. Choice therapy has been bilateral adnectomy without opening the ovarian cyst and without trauma to the ovary capsula. Adnectomy was performed by bipolar coagulation and sharp preparation. In every case the specimen was positioned intact in a "Lap-Sac" and then removed via second puncture. In case of ultrasonographic or laparoscopic-macroscopic conspicuous findings an obligatory fast microscopic random sample was performed.

In one case the microscopic test sample revealed carcinoma of the ovary--the operation was terminated by standard laparotomy. No other cases showed signs of malignancy. There were no peri- or postoperative complications. The average operation lasted 35 min (20-80 min), all operations were performed without significant blood-loss. Usually the patients were discharged at the 4th to 6th postoperative day.

This operation-technique guaranteed "oncological aseptic" results at any time of operation. Therefore you can waive the standard laparotomy for the benefit of laparoscopy in many elderly patients even with suspicious findings.