Laparoscopic adnexal surgery during pregnancy

Adnexal masses diagnosed in a gravid woman sometimes must be surgically evaluated and treated during the pregnancy. A laparoscopic approach may have several advantages over laparotomy, but only one case of laparoscopic adnexal surgery during pregnancy has been previously reported. Two pregnant patients with acute pelvic pain and adnexal masses were treated by operative laparoscopy. One patient had a large benign cystic teratoma and the other had torsion of the fallopian tube secondary to a paratubal cyst. Cystectomies were performed in both women, and in the second patient the tube was reduced and conserved. It appears that with proper care of surgical technique and caution to exclude malignancy, laparoscopy may be performed successfully to remove adnexal masses during the second trimester of pregnancy.