Role of minimally invasive surgery in complex adnexal tumours and ovarian cancer

Table 2 Surgical manoeuvres in order to decrease port-site metastasis in the laparoscopic management of complex adnexal masses

Using wound protectors

Minimizing tumour manipulation

Anchoring ports to prevent dislodgment

Avoiding carbon dioxide leakage and sudden desufflations

Using gasless laparoscopy

Irrigating and suctioning the abdomen, instruments and ports before removal

Using heparin or 0.25%-1% povidone-iodine solution to irrigate wounds and the abdomen

Excising trocar sites and deliberate closure of all abdominal layers including the peritoneum after laparoscopy; or postoperative port-site radiation

Resuming definitive surgery or chemotherapy early

Using 5-fluorouracil, topical taurolidine or intraperitoneal endotoxin