Laparoscopic management of large ovarian cysts at a rural hospital

Shindholimath, Vishwanath V; Jyoti, SG; Patil, K. A.; Ammanagi, A S

doi:10.4103/0974-1216.71616

Cited by 12 publications

(6 citation statements)

References 12 publications

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“…Laparoscopic surgery is considered as the treatment of choice in the treatment of small to moderate sized adnexal masses, but experience related to laparoscopic management for large ovarian masses remains limited. 4 The size 10cm was used as a definition for a large ovarian cyst in the present study, similar to a study done by Ou CS et al 5,6 In the present study, the mean age of the patients was 32 years and range being 14 to 43years, compared to a study by Alobaid et al, in which the mean age was 30.6 years. 2 The chief complaint was abdominal pain in 65.7% of patients in the current study, which was similar to a study by Eltabbakh et al, where in 69.7% patients presented with abdominal pain and Lim et al in which 29.6% patients presented with abdominal pain.…”

Section: Discussionsupporting

confidence: 80%

Large adnexal mass: is laparoscopic surgery a safe option?

Talwar

Shree

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Laparoscopic surgery is regarded as the gold standard for management of adnexal tumours due to many advantages. Currently, the exact size of the adnexal tumour contraindicating laparoscopic management has not been clearly defined. Some studies suggest laparotomy for the treatment of adnexal tumours larger than 8 to 10 cm. Risk of malignancy increases with large cysts. Issues with operation of huge adnexal masses are limited surgical field, difficulty in inserting trocars and removing the specimen without rupture. This study aims to evaluate the feasibility and surgical outcomes of laparoscopic surgery for large adnexal masses.Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, JSS Medical College, Mysuru.Results: 35 patients with large adnexal masses, which were thought to be benign, were subjected to laparoscopic surgery. Mean diameter of masses as per the pre-operative ultrasound measurements was 12.2cm (range: 10.1-20.4cm). The mean operative time was 51.15minutes, estimated blood loss was 85.4ml, duration of postoperative hospital stay was 2.8 days. Serous cystadenoma was the most common histopathological finding. However, one case of borderline tumour was found.Conclusions: The potential risk of malignancy is the most important limiting factor for laparoscopic management of large ovarian cysts. Therefore, it is necessary to establish risk profiles of patients with adnexal masses in order to benefit from minimally invasive surgery wherever possible. The current study supports laparoscopic management of large ovarian cysts as a technically feasible method if proper case selection is made.

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Section: Discussionsupporting

confidence: 80%

Large adnexal mass: is laparoscopic surgery a safe option?

Talwar

Shree

2019

Int J Reprod Contracept Obstet Gynecol

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“…Various techniques have been described in literature to overcome this difficulty such as 1) Palmer's point access or 2) open laparoscopy followed by intentional ( Figure 1) trocar puncture of the cyst under visualisation to deflate the cyst. 5,6 In this study both the above techniques were adopted depending on the case and without much difficulty. In one study, transabdominal drainage under ultrasonographic control followed by laparoscopy and port/veress insertion directly into the cyst blindly has also been described.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic management of large ovarian cysts

Beeresh¹,

Doopadapalli²,

Vimala³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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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.

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“…The management of the patients who present with ovarian cyst is often controversial especially in reproductive age. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Ovarian cysts were often managed by laparotomy and laparoscopic management of ovarian cysts has been explored as an alternative, primarily because of the reduced surgical morbidity, reduction in pelvic adhesions, shorter recovery period and reduced cost. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] If surgery is indicated, a laparoscopic approach is generally considered to be the gold standard management of benign ovarian masses.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] If surgery is indicated, a laparoscopic approach is generally considered to be the gold standard management of benign ovarian masses. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] The main concern is determination of benign verses malignant nature of the masses pre-operatively and intra-operatively. However, laparoscopic evaluation of equivocal masses on pre-operative assessment can prevent many laparotomies, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] The main concern is determination of benign verses malignant nature of the masses pre-operatively and intra-operatively. However, laparoscopic evaluation of equivocal masses on pre-operative assessment can prevent many laparotomies, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] and with this background, this study aimed to analyze all benign ovarian masses treated laparoscopically to assess safety, feasibility and outcome of such surgeries.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic Management of Benign Ovarian Masses

Saha

Karki²

2013

J Nepal Med Assoc

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Introduction: Laparoscopic surgery is one of the most common procedures performed for benign ovarian masses. The aim of the study was to analyze all benign ovarian masses treated laparoscopically to assess safety, feasibility and outcome.Methods: A prospective study was carried out at Kathmandu Medical College Teaching Hospital, Sinamangal, Nepal. All the patients undergoing laparoscopic surgery for benign ovarian masses from 1st January 2012 to 31st December 2012 were included in the study. The pre-operative findings, intra-operative findings, operative techniques and post-operative complications were analyzed.Results: Thirty-six patients were taken for the study. Two cases were excluded since intra-operatively they were tubo-ovarian masses. The most common tumor was dermoid cyst (n=13; 38.23%) and endometriotic cyst (n=14; 41.17%). Out of 34 cases, five cases of endometriotic cyst (14.70%) were converted to laparotomy due to severe adhesions and four cases of endometriotic cyst underwent deroofing surgery. Two cases underwent laparoscopic assisted vaginal hysterectomy with bilateral salphingo-oopherectomy. Successful cystectomies were carried out in 22 cases. None were malignant. Major complications were not noted while minor complications like port-site infection (n=3; 8.82%) and subcutaneous emphysema (n=1; 2.9%) were present.Conclusions: Laproscopic management of benign ovarian masses is safe and feasible.

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Laparoscopic management of large ovarian cysts at a rural hospital

Cited by 12 publications

References 12 publications

Large adnexal mass: is laparoscopic surgery a safe option?

Large adnexal mass: is laparoscopic surgery a safe option?

Laparoscopic management of large ovarian cysts

Laparoscopic Management of Benign Ovarian Masses

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