A Modified Technique to Reduce Spillage and the Operative Time in Laparoscopic Dermoid Cyst Excision

Ulubay, Mustafa; Keskin, Uğur; Fidan, Ulaş; Öztürk, Mustafa; Karaca, Rıza Efendi; Yüksel, Beril; Yenen, Müfit Cemal; Ergün, Ali

doi:10.1089/lap.2014.0497

Cited by 6 publications

(5 citation statements)

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“…The technique of controlled drainage to endoscopic bag may prevent the intraperitoneal spillage, reduce operative time, and simplify the procedure. 13,14 Laberge and Levesque suggest incomplete tumor removal as a cause of relapse in MOT and claim that laparoscopic approach may cause difficulty of peeling off the cyst wall completely. 11 In our group, all recurrences were observed in patients operated with open approach, although the recurrence after 12 months in a first patient operated via OST suggests the validity of this theory.…”

Section: Discussionmentioning

confidence: 99%

Ovarian Sparing Surgery in Mature Ovarian Teratomas in Children: A 20-Year Single-Center Experience

et al. 2020

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Introduction Despite its benign nature, possible bilateral presentation, and a very good prognosis, ovarian sparing tumorectomy (OST) in mature ovarian teratoma (MOT) is not commonly performed. Unilateral oophorectomy has physiological consequences, while bilateral is devastating. The aim of this study is promotion of OST in MOT among children. Materials and Methods We reviewed 120 patients operated for MOT between August 1999 and 2019. Results Ovariectomy was performed in 15 patients (14 between 1999 and 2009 and 1 after 2010). In 105 girls, OST was possible including 32 with ovarian torsion. The approach was laparoscopy in 30 girls (11 conversions) and laparotomy in 94. Intra-abdominal spillage occurred in 30% of laparoscopic dissections. Postoperative morbidity was not associated with surgical approach (p = 0.613) or presence of adnexal torsion (p = 0,608). Follow-up was from 4 months to 9 years (median = 4 years) with access to 90% of patients. Bilateral lesions were observed in six (synchronous in five and metachronous in one) patients. Recurrence appeared in three patients operated via laparotomy and OST (after 12, 46, and 74 months). In one girl, asynchronous contralateral MOT was found 5 years after unilateral oophorectomy. Ovarian regeneration after torsion was observed in sonography in 84.4% of the patients. None of the patients experienced chemical peritonitis or malignant tumor transformation. Conclusion OST is safe and effective and should be the first-line procedure in children. Laparoscopy and laparotomy constitute a complementary approach to MOT. Ultrasound follow-up is necessary to monitor recurrence, contralateral disease, and ovarian regeneration.

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Section: Discussionmentioning

confidence: 99%

Ovarian Sparing Surgery in Mature Ovarian Teratomas in Children: A 20-Year Single-Center Experience

et al. 2020

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“…[13] Surgical techniques such as the use of endobag or purse-string suture have been introduced to prevent complications associated with leakage of cyst contents. [6][7][8]14] In cases of cyst rupture, jet-wash irrigation with large amounts of fluid and removal of tiny particles of cyst contents is considered the gold standard procedure to avoid complications, but it has the disadvantage of requiring a long time. [15,16] Despite the rare incidence of short-and long-term outcomes associated with intraoperative spillage, surgeons should make efforts to prevent intraperitoneal spillages.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, to minimize spillage during cystectomy, a surgical technique within the bag has been introduced. [6][7][8] However, most studies have used an endoscopic retrieval bag to minimize the risk of intraoperative spillage of the ovarian cyst content during removal of the cyst wall from the abdominal cavity. [3,[8][9][10] In this study, we evaluated the effects of within-endobag cystectomy that performing the entire cystectomy procedure within an endobag by comparing the surgical and postoperative clinical data with those of a group of patients with ovarian dermoid cysts who did not use an endobag during cystectomy.…”

Section: Introductionmentioning

confidence: 99%

Effect of within-endobag method during laparoscopic ovarian cystectomy of dermoid cyst: A retrospective study

et al. 2023

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This study aimed to evaluate the effect of within-endobag cystectomy during and after laparoscopic ovarian cystectomy in patients with dermoid cysts. We retrospectively analyzed 84 patients with ovarian dermoid cysts who underwent laparoscopic ovarian cystectomy. In 30 patients, the affected ovary was placed in an endobag before cystectomy and cystectomy was performed within an endobag (within-endobag group), while the remaining 54 patients underwent standard cystectomy without this step (without-endobag group). After cystectomy, the cyst wall was placed in an endobag and was removed from the abdomen. Compared with the without-endobag group, the within-endobag group had a significantly lower rate of cyst content spillage (23.3% vs 72.2%, P < .001) and significantly shorter operation times when the cysts ruptured (23.4 ± 8.6 minutes vs 51.2 ± 28.6 minutes, P < .001). Whereas there was no significant difference in operation time in the absence of cyst rupture between 2 groups (21.2 ± 8.8 minutes vs 31.1 ± 17.4 minutes, P = .111). In patients with cyst rupture, according to the cyst size increase, the operation time was significantly prolonged without-endobag, whereas no significant prolongation was observed in within-endobag cystectomy. Except for operation time, there were no significant differences in cyst length, pain on the first day after surgery, hemoglobin loss, hospital stay, and inflammatory markers (C-reactive protein and white blood cell counts) in both ruptured and unruptured cases between the 2 groups. There were no postoperative complications in the within-endobag group, but 2 cases of perioperative complications occurred in the without-endobag group. No chemical peritonitis due to spillage of the cyst contents was observed in either group. Laparoscopic ovarian cystectomy performed within-endobag can reduce both the spillage rate of cyst contents and operation time regardless of cyst size in patients with ruptured cysts. Therefore, this technique is a good surgical option for the laparoscopic ovarian cystectomy of large dermoid ovarian cysts.

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“…Despite our reassuring results regarding the shortand long-term outcomes associated with intraoperative spillage, every effort should be made to prevent intraoperative spillage, mainly in dermoid cysts, using the best available operative technique. Ulubay et al [47] described a technique of controlled dermoid cyst drilling contained in a bag, followed by excision and removal of the cyst in the same bag to prevent intraperitoneal spillage. Similarly, many studies found that using an endoscopic retrieval bag can minimize the risk of intraoperative spillage of ovarian cyst content [28,32,48].…”

Section: Discussionmentioning

confidence: 99%

Short- and Long-Term Complications of Intraoperative Benign Ovarian Cyst Spillage: A Systematic Review and Meta-analysis

Eisenberg

Volodarsky‐Perel

Brochu

et al. 2021

Journal of Minimally Invasive Gynecology

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A Modified Technique to Reduce Spillage and the Operative Time in Laparoscopic Dermoid Cyst Excision

Abstract: Controlled drilling, excision, and removal of a dermoid cyst inside the same bag seems to be a feasible method to prevent intraperitoneal spillage and to reduce the operative time.

Cited by 6 publications

References 11 publications

Ovarian Sparing Surgery in Mature Ovarian Teratomas in Children: A 20-Year Single-Center Experience

Ovarian Sparing Surgery in Mature Ovarian Teratomas in Children: A 20-Year Single-Center Experience

Effect of within-endobag method during laparoscopic ovarian cystectomy of dermoid cyst: A retrospective study

Short- and Long-Term Complications of Intraoperative Benign Ovarian Cyst Spillage: A Systematic Review and Meta-analysis

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