This advanced laparoscopic surgery video demonstrates fertility-preserving management of ovarian torsion in an 18-year-old unmarried girl presenting with a large torsed tubo-ovarian mass. The surgeon performs meticulous blunt adhesiolysis to restore normal pelvic anatomy while avoiding thermal injury to the edematous tissues. Following careful detorsion, ovarian viability is reassessed, allowing ovarian cystectomy and reconstruction instead of oophorectomy. The video also demonstrates the "Hot Dog in Double Bun" ovariopexy technique to prevent recurrent torsion while maintaining tubal integrity. Throughout the procedure, emphasis is placed on preserving ovarian reserve, minimizing tissue trauma, and restoring normal pelvic anatomy. Long-term follow-up confirms normal ovarian vascularity and complete recovery, making this an excellent educational resource for gynecologic endoscopic surgeons.