Pneumoperitoneum is done by insertion of the verress needle at the inferior edge of the umbilicus putting into consideration the following tests:~Needle test: Verress needle patency check.~Hissing phenomenon: Needle introduced by open valve mechanism.~Aspiration test: Placing a drop of water on the opening of the needle and examine its disappearance into the abdomen.~Volume test: Changes occurred in the intra abdominal pressure during gas insufflations.~Intra abdominal pressure 12-16 mmHg usually suitable for this pelvic surgery. Introduction of the laparoscopic instruments all in its place~Laparoscopic telescope : From the inferior edge of umbilicus through trocar and sleeve which inserted by corkscrew technique then removed to allow the telescope insertion which connected to light source , camera head and color monitor.~2nd and 3rd punctures were done allowing another two graspers to be inserted usually at a point represent outer 1/3 of the lateral abdominal wall in an imaginary line from umbilicus to iliac bone.~Puncturing technique :~Fixation of one ovary away from intestine by grasping the ovarian ligament with the traumatic grasper which allow good exposure of the ovary and allow drilling .~Drilling needle was introduced and connected by monopolar current, held against ovarian surface for 4 seconds using a power of 40 watt, 4 puncture was done in each ovary with putting into consideration that the puncture must be not superficial and it must go deep through the main substance of the ovary.~Cooling of the ovary by lactated ringer's solution, finally removal of all instruments under vision after exclusion of any complication .
Pneumoperitoneum is done by insertion of the verress needle at the inferior edge of the umbilicus putting into consideration the following tests:~Needle test: Verress needle patency check.~Hissing phenomenon: Needle introduced by open valve mechanism.~Aspiration test: Placing a drop of water on the opening of the needle and examine its disappearance into the abdomen.~Volume test: Changes occurred in the intra abdominal pressure during gas insufflations.~Intra abdominal pressure 12-16 mmHg usually suitable for this pelvic surgery. Introduction of the laparoscopic instruments all in its place~Laparoscopic telescope : From the inferior edge of umbilicus through trocar and sleeve which inserted by corkscrew technique then removed to allow the telescope insertion which connected to light source , camera head and color monitor.~2nd and 3rd punctures were done allowing another two graspers to be inserted usually at a point represent outer 1/3 of the lateral abdominal wall in an imaginary line from umbilicus to iliac bone~Puncturing technique :~Fixation of one ovary away from intestine by grasping the ovarian ligament with the traumatic grasper which allow good exposure of the ovary and allow drilling .~Drilling needle was introduced and connected by monopolar current, held against ovarian surface for 4 seconds using a power of 40 watt, 4 puncture was done in each ovary with putting into consideration that the puncture must be not superficial and it must go deep through the main substance of the ovary.~Cooling of the ovary by lactated ringer's solution, finally removal of all instruments under vision after exclusion of any complication .