“…In recent years dermoid cysts have increasingly been removed by laparoscopy, and with this technique spillage has been reported in 54% of cases, ranging from 0 to 100% (table 1) [8,9,12,13,16,17,18,19,20,21,22,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41]. In order to reduce the risk of spillage during laparoscopy, some authors propose to remove dermoid cysts via culdotomy through an incision on the posterior vaginal fornix [26,35,42,43,44], but with this technique Teng et al [31] reported 6 cases of spillage from 14 cysts (43%); Reich et al [26] reported 9 cases of spillage in 25 cysts removed vaginally (36%), and in the experience of Nezhat et al [35] spillage occurred in 4 of 9 cysts (44%).…”