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By the turn of the century laparoscopic surgery may become the standard of care, replacing laparotomy except some cases with extensive disease, because it has many advantages including less pain, decreased postoperative adhesion formation, short hospitalyzation, rapid recovery time. In order to adapt such a trend, one, must learn various operative skills step by step. Laparoscopic management of the adnexal mass is one of the -most popular operation done by laparoscopy. Before deciding to remove adnexal mass laparoscopically, careful patient seleciion is critical. Important factors for patient selection are results of menopausal status, :physical examination, ultrasound findings, and CA125. If malignancy is suspicious during operation, one must convert to laparotomy under the same anesthesia. So there must no delay in definitive surgery. After resection of mass, it is preferred to temove it intact from the abdominal cavity using various methods including culdotomy, extension of trocar site, using endopouch. Before finishing operation, intraabdominal pressure should be reduced to 5-8mmHg and reevaluate operatuion site to secure competence of hemostasis.
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