Comparative Study of Laparoscopic Adnexal Surgery Versus Open Adnexal Surgery for Adnexal Masses

Introduction Adnexal masses are among the most frequently encountered gynecological conditions and may require surgical intervention when symptomatic or suspicious for malignancy. With advances in minimally invasive techniques, laparoscopy has emerged as an alternative to conventional laparotomy, offering potential benefits in terms of perioperative morbidity and recovery. The study aimed to compare laparoscopic adnexal surgery and open adnexal surgery for adnexal masses with respect to intraoperative and postoperative outcomes. Materials and methods This randomized controlled trial was conducted in the Department of Obstetrics and Gynecology, Shri B. M. Patil Medical College, Vijayapura, Karnataka, India, from March 2024 to October 2025. Sixty women with adnexal masses requiring surgical management were randomly allocated into two groups: laparoscopic surgery (n=30) and open surgery (n=30). Outcomes assessed included postoperative complications (primary outcome) and secondary outcomes such as duration of surgery and anesthesia, intraoperative blood loss, postoperative hemoglobin levels, analgesic requirement, need for blood transfusion, and duration of hospital stay. Data were analyzed using appropriate statistical tests, and a p-value <0.05 was considered statistically significant. Results Both groups were comparable with respect to baseline demographic characteristics. Laparoscopic surgery was associated with significantly lower intraoperative blood loss (p<0.001), reduced postoperative analgesic requirement (p<0.001), shorter hospital stay (p<0.001), and better preservation of postoperative hemoglobin levels (p=0.021). None of the patients in the laparoscopic group required blood transfusion, whereas five (16.7%) patients in the open surgery group did (p=0.018). Although laparoscopic procedures required a longer duration of surgery and anesthesia, complication rates were comparable between the two groups, with only one wound infection reported in the open surgery group. However, the low incidence of complications limits a definitive comparison of safety outcomes. Conclusion Laparoscopic surgery for adnexal masses offers significant advantages over open surgery in terms of reduced blood loss, faster recovery, and lower postoperative morbidity. It represents a favorable surgical option for improving short-term perioperative outcomes; however, larger studies are required to establish definitive conclusions regarding comparative safety.