Introduction Large ovarian cysts are conventionally managed by laparotomy. This study was undertaken to assess the feasibility and outcome of laparoscopic surgery for the management of large ovarian cysts. Settings and design Rural teaching hospital – prospective study. Materials and methods Thirty-eight patients from January 2014 to December 2016 presumed to be with large ovarian cyst were managed laparoscopically. Preliminary evaluation suggestive to be of benign ovarian cyst by history, clinical examination, sonographic imaging, and basic serum marker were only included in this study. The cysts were aspirated initially, followed by cystectomy, oophorectomy, or total hysterectomy depending on age, parity, coexisting pathology, and desire for future fertility. Results Out of 38 cases, 6 were nonovarian adnexal masses. Eight of the 32 cases who presented with pain due to torsion were managed on emergency basis; rest of the cases were operated electively. Mean operating time was 90 minutes. Mean size of the cyst was 16 cm. One case of borderline malignancy was detected and the rest showed benign pathology. Six of the cases required minilaparotomy for specimen removal. Most women were successfully treated laparoscopically without any complications, and conversion to laparotomy was required in three cases. Conclusion With proper patient selection and exclusion of malignancy, laparoscopic management of large ovarian cyst by gynecologist is feasible. How to cite this article Beeresh CS, Doopadapalli D, Vimala KR, Lingegowda K. Laparoscopic Management of Large Ovarian Cysts. Int J Gynecol Endsc 2017;1(1):18-21.

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Background: Large ovarian cysts are conventionally managed by laparotomy. This study was undertaken to assess the feasibility and outcome of laparoscopic surgery for the management of large ovarian cysts.Methods: Thirty-eight patients from January 2014 to December 2016, presumed to be large ovarian cyst were managed laparoscopically. Preliminary evaluation suggestive to be of benign ovarian cyst by history, clinical examination, sonographic imaging and basic serum marker were only included in this study. The cysts were aspirated initially followed by cystectomy, oophorectomy or total hysterectomy depending on age, parity, coexisting pathology and desire for future fertility.Results: Out of 38 cases, 6 were non-ovarian adnexal masses. 8 out of rest 32 cases presented with pain due to torsion were managed on emergency basis, rest of the cases were operated electively. Mean operating time was 90 minutes. Mean size of the cyst was 16 cms. One cases of borderline malignancy were detected and the rest showed benign pathology. Three of the cases required mini Laprotomy for specimen removal. Most of women were successfully treated laparoscopically without any complications and conversion to laparotomy was required in 3 cases.Conclusions: With proper patient selection and exclusion of malignancy, laparoscopic management of large ovarian cyst by general gynecologist is feasible.

Background: Endometrial cancer is currently the most common gynaecological malignancy in developed countries. The incidence of endometrial cancer is 3.7% to 17.9% in women with abnormal uterine bleeding. Most patients who have endometrial cancer present with postmenopausal uterine bleeding early in the development of the disease. Application of an appropriate and accurate diagnostic test in this situation usually results in early diagnosis, timely treatment, and a high cure rate Methods: A total of 60 postmenopausal women attending the outpatient and inpatient cases in Department of Obstetrics and Gynaecology of PESIMSR, Kuppam, AP from May 2017 to April 2019 were included for this study. All women were subjected to transvaginal ultrasonography to look for endometrial thickness and endometrial morphological characteristics and the same was compared to histopathology findings obtained by Pippel biopsy of endometrium. Results: The Mean endometrial thickness in atrophic endometrium was 3.86mm.The Mean endometrium in carcinoma endometrium was 21.29mm. Taking 4mm as cut off to define abnormal endometrium; this had a sensitivity of 85.71%, specificity of 62.50%, PPV of 66.66%, NPV of 83.33%. Conclusions:The reduction to three criteria in the diagnostic formula (with the simple rule: benign ifendometrial thickness is<4 mm, endometrial structure is homogeneous, and endometrial-myometrial border is regular; otherwise pathological) resulted in a useful sonmorphological differentiation of the endometrial findings and averts unnecessary invasive intervention like endometrial biopsy in women with benign cause of postmenopausal bleeding

Background: Pelvic hemorrhage is associated with a great degree of morbidity and mortality and has to be controlled immediately. Ligation of the internal iliac arteries is a method to achieve the goal. We conducted this study to assess the outcome, effectiveness and complications of internal iliac artery ligation (IIAL) in controlling postpartum haemorrhage.Methods: This study was a retrospective study conducted in a rural tertiary referral centre from April 2015 to March 2018. IIAL was performed in women with PPH either at caesarean section or at laparotomy performed at a variable time after vaginal or caesarean delivery.Results: Over the study period of 3 years, 29 cases of IIAL were performed. The most common indication for IIAL was atonic PPH. Uterine salvagability was 62% in this study.Conclusions: All obstetric surgeons should be fully aware of the indications, timing and technical aspects of IIAL. Bilateral internal iliac artery ligation remains a safe, fast, effective and life saving salvage procedure which should be encouraged and used routinely by obstetricians when faced with cases of severe obstetric hemorrhage, especially in young women of low parity.