Laparoscopic Management of Ovarian and Paraovarian Masses Using Radiofrequency

Starting in 1994, we conducted a prospective and descriptive study to asses the efficacy of operative video laparoscopy in our institution for the management of benign ovarian and paraovarian masses. We operated on 106 women with a diagnosis of benign mass established by clinical, ultrasound, and biochemical examinations. The average size of the masses was 53.7 mm (range 16-120 mm). We performed a unilateral cystectomy in 55.3% of women, unilateral coagulation and cystectomy in 16.7%, and drainage and fenestration with radiofrequency current in 14.9%. All procedures were done on an outpatient basis and none were converted to laparotomy. One minor complication occurred. Histopathologic examinations reported 28 unilateral endometriomas, 20 dermoid cysts, 17 paraovarian cysts, 16 serous cysts, 10 hemorrhagic cysts, 9 functional cysts, 2 bilateral endometriomas, 2 serous cystadenomas, 1 mucinous cyst, and 1 serous cyst. No malignancy was found. Mean follow-up for the entire series was 8.4 months, and 75% of the women were followed for at least 11 months. Ultrasound examination found recurrences in seven patients (6.6%), all of which were operated; histopathologic recurrence was found in four (total recurrence 3.7%). Operative laparoscopy with radiofrequency is beneficial and safe in women who have a complete preoperative evaluation that indicates a benign mass.