The adnexa refers to the area adjacent to the uterus, containing the ovaries, fallopian tubes (also known as oviducts), and connective tissues. Adnexal surgery is used to address issues with these structures. While open surgery can be performed, involving a larger incision for direct visualization and manipulation of tissues, laparoscopic surgery is usually preferred. This minimally invasive procedure involves making several small incisions in the abdominal wall. The abdomen is inflated with carbon dioxide gas, and a light and camera are inserted to provide a clear view. Specially designed surgical instruments are then inserted through the incisions to perform the procedure.
One common type of adnexal surgery is tubal ligation (commonly known as "having your tubes tied"). This can be achieved in several ways. In some cases, a device is used to close off the fallopian tubes. In other cases, part of the fallopian tube is removed (transection) or burned away (fulguration).
Ovarian cysts are fluid-filled growths on the ovary. While these cysts are often harmless and asymptomatic, they can sometimes cause symptoms. Laparoscopic surgery can be used to remove ovarian cysts. In some cases, the entire ovary is removed, while in others, only the portion of the ovary containing the cyst is removed. If problematic cysts are present on both ovaries, both ovaries may be removed, which will immediately induce menopause in women who have not yet gone through natural menopause.
In some cases, an ovarian cyst may raise concerns about cancer. Similarly, growths in the adnexa may potentially be cancerous. During laparoscopic surgery, these growths can be biopsied. A biopsy involves taking a small sample of tissue, which is sent to a laboratory for analysis to determine if it is cancerous. If a growth is small enough, the entire growth may be removed. However, if it is larger or has invaded deeper tissues, only a portion may be taken for analysis. Additionally, fluid from a cyst can be collected and analyzed to check for the presence of cancer cells.