Management of Adnexal Torsion in Advanced Pregnancy

401 Views | Sep 26, 2019

Authors: Tina Ngan, Peter Thiel, Huse Kamencic

Affliations: University of Saskatchewan

Adnexal torsion is a common gynecological pathology representing 2.7% of all gynecological emergencies. The management of adnexal torsion presents a unique challenge when encountered in advanced pregnancy. This challenge is further complicated by a paucity of literature discussing management approaches and outcomes in pregnancy. The objective of this video is to review the risk factors, perioperative planning and management of adnexal torsion in advanced gestation. The stepwise minimally invasive approach consists of identification of the anatomy, determination of accessory port placement, detorsion of the adenexa, and finally removal of the specimen. This surgical approach will be demonstrated by a case of adnexal torsion in pregnancy with a focus on pearls to utilize and pitfalls to avoid. Furthermore, general tips for laparoscopic surgery in pregnancy will be covered and demonstrated in the video.