The laparoscopic management of large ovarian cysts

Quinlan, D.

doi:10.1007/s13224-010-0023-2

Cited by 6 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dermoid cysts constitute 20%-25% of ovarian tumors (3,4), and account for up to 70% of benign ovarian neoplasms occurring in women of the childbearing years (15-45 years) (5). Laparoscopy is the standard treatment for excision of benign ovarian cysts and provides many advantages over laparotomy (4)(5)(6)(7)(8)(9)(10)(11)(12). Though laparoscopic surgery is associated with a longer operating time compared to laparotomy, the advantages are: less postoperative pain, reduced postoperative analgesic need, earlier mobilization which reduces chances of deep venous thrombosis, short hospital stay, reduced infectious morbidity, earlier recovery, better quality of life with early return to normal activity during the postoperative period and acceptable mini incisions (3)(4)(5)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Use of Ovarian Wall as an Endobag During Laparoscopic Removal of a Giant Dermoid Cyst: A New Approach

Alamooti¹,

Sushama²

2018

International Journal of Women’s Health and Reproduction Scienc

View full text Add to dashboard Cite

Introduction Asymptomatic adnexal masses are diagnosed incidentally in 4% of pregnancies (1). Majority of them are benign and are of ovarian origin (1). Giant cysts, though uncommon, are challenging to the surgeon, in their removal. Such huge cysts were conventionally managed by laparotomy. In spite of all the advantages inherent to minimal access surgery, many surgeons refrain from removing them laparoscopically due to the risk of malignancy and the spillage of contents. This is a case report where a giant benign cystic teratoma (dermoid cyst) of 27 cm size was successfully excised laparoscopically. The greatest challenge was the retrieval of the huge specimen which would not fit into the largest endobag. The cyst was successfully removed using the ovarian wall as the endobag, which curtailed peritoneal soiling by the intra-cystic contents. We hope that this paper will add to the emerging evidence on the safety of laparoscopy in removing such gigantic cysts, refuting the myth that spillage of contents and its complications increases in proportion with cyst size. To the best of our knowledge, this is the largest reported ovarian cyst, removed laparoscopically in Qatar. Case Presentation The patient was a 32-year-old woman Gravida 3 Para 2 Live 2, who was referred to Obstetrics and Gynecology Department at 9 weeks of gestation with missed miscarriage and an incidental finding of a huge 21-cm ovarian cyst by ultrasonography. She was asymptomatic and was diagnosed to have this ovarian cyst during her viability scan at 7 weeks of gestation. On evaluation, she had no risk factors suggestive of a malignant potential like loss of appetite, abdominal bloating, loss of weight, dyspepsia or family history of breast/ gastrointestinal/ ovarian cancer. Physical examination showed a pelvic mass occupying the hypogastrium, bilateral iliac quadrants and reaching up to the umbilicus. The mass was not tender and there was no ascites, pleural effusion, palpable lymph nodes or hepatomegaly. No pressure symptoms like varicose veins were present. A repeat abdominopelvic ultrasound showed a 21-cm adnexal multi-locular cyst/cystadenoma with no solid component. The tumor markers CA-125, serum alpha-fetoprotein (AFP), serum lactate dehydrogenase (LDH), carcinoembryonic antigen (CEA) were tested and found to be within normal limits. The management options, both laparotomy and laparoscopic surgery, were discussed with the patient, including their pros and cons. Patient opted for laparoscopic removal as her primary concern was to avoid a large abdominal scar. Informed consent was obtained, and she was posted for elective operative laparoscopy after Abstract Objectives: Incidental finding of an asymptomatic giant ovarian mass is unusual during pregnancy. Addressing such voluminous cysts laparoscopically is controversial, and a challenge to the surgeon. This article describes on how we tackled a 27-cm ovarian cyst using the ovarian wall itself as the endobag. Case Presentation: A 32-year-old lady was referred to Obstetrics and Gynecology Depar...

show abstract

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic management of large ovarian masses, however, is still under debate (5,10,16,18). Conventionally, these huge masses were dealt with by open laparotomy (8)(9)(10)(11)13). There is increasing evidence that the vast majority of large adnexal masses can be resected laparoscopically (12,14,(16)(17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

The Use of Ovarian Wall as an Endobag During Laparoscopic Removal of a Giant Dermoid Cyst: A New Approach

Alamooti¹,

Sushama²

2018

International Journal of Women’s Health and Reproduction Scienc

View full text Add to dashboard Cite

show abstract

“…On searching the literature it was not mentioned of the possible dissemination of cells in borderline Tumours [7].…”

Section: Discussionmentioning

confidence: 99%

“…There was no evidence of chemical peritonitis in the post-operative period It has been shown that in the event of accidental rupture of the capsule, irrigation with copious saline reduces post-operative chemical peritonitis to less than 1% [10,11]. Also, reverse trendelenberg position is important at the end of the procedure to optimize the results of the lavage [7].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Managing Adnexal Masses: A Medical Quandary

Kapoor¹

2013

JCDR

View full text Add to dashboard Cite

Laparoscopic management of large ovarian cysts

Beeresh¹,

Doopadapalli²,

Vimala³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

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.

show abstract

The laparoscopic management of large ovarian cysts

Cited by 6 publications

References 9 publications

The Use of Ovarian Wall as an Endobag During Laparoscopic Removal of a Giant Dermoid Cyst: A New Approach

The Use of Ovarian Wall as an Endobag During Laparoscopic Removal of a Giant Dermoid Cyst: A New Approach

Managing Adnexal Masses: A Medical Quandary

Laparoscopic management of large ovarian cysts

Contact Info

Product

Resources

About