Perioperative management - Adnexectomy, laparoscopic, robot-assisted laparoscopy (DaVinci)

Conducting an adequate medical history and gynecological examination. The examination is intended to identify other pathologies of the uterus or adnexa, potentially avoiding surgery. Additionally, determining the actual level of distress or needs of the patient. Subsequently, informing about alternative treatment options.

Laboratory examination (depending on the needs of the clinic)

Further examinations (MRI, CT) are only useful with appropriate indications.

• Wound healing disorder
• Infection, rarely intra-abdominal abscess requiring revision or percutaneous drainage
• Postoperative ileus
• Adhesions
• Injuries to other organs, intestines, bladder, ureter
• Subcutaneous emphysema
• Post-laparoscopic shoulder pain syndrome
• General surgical risks (bleeding, rebleeding, thrombosis, embolism, HIT)
• Possible conversion to open technique in case of complications
• Urinary retention
• Positioning injuries
• Burns
• Dissemination of benign as well as malignant cells, in rare cases of malignancy, worsening prognosis
• Information about alternative treatment methods
• Premature menopause

• no preoperative bowel evacuation
• no shaving
• if necessary, antibiotic prophylaxis during induction of anesthesia (cephalosporins of group 2 and metronidazole), depending on the extent of the surgery