At present, the majority of laparoscopic operations are performed under general anaesthesia, as it controls surgical pain and improves patient comfort using pneumoperitoneum and the Trendelenburg position. However, some laparoscopic procedures, such as adnexectomies, can potentially be performed under epidural anaesthesia with a purposefully selected and motivated patient managed by prepared surgical and anaesthesia care teams working together effectively. This study reports the case of a 63-year-old female patient with major respiratory failure who underwent laparoscopic bilateral adnexectomies under epidural anaesthesia.