ABSTRACT
Mobilization of the Adnexal Mass Two situations may be encountered: the adnexal mass is immediately visible because the adnexa is above the uterus (Fig. 3), or the adnexal mass is located in the posterior cul-de-sac and is hidden behind the uterus. In the first situation, it is important to grasp the adnexa before puncture of the cyst to avoid the mass “disappearing” after drainage into the posterior cul-desac. In the second situation, the mass should first be lifted into the abdomen using probes and graspers. The mass should be pulled slowly to avoid trauma of the ovarian ligaments. This may be facilitated by using a lateral tilt of the table toward the opposite side, which will shift the uterus to the opposite side and free some space, making it easier to mobilize the adnexa. Simultaneous vaginal examination may also be helpful to push the adnexal mass towards the abdomen. In most cases, it is possible to avoid blind vaginal rupture of the adnexal mass.
