Usefulness, Accessibility and Safety of using a Bag for Ovarian Cystectomy

Abstract

This is a prospective study, which was made to evaluate the usefulness of laparoscopic cystectomy of unopened ovarian cyst using a waterproof laparoscopic bag. Aim:The aim is to hinder intraperitoneal leakage from rupture of a cyst 170 patients participated in this study. In 3 women, the cyst were on both ovaries The laparoscopic sac did not rupture in any women.Results: Mean diameter of the cysts was 5.1, 5.8, 5.3, 6, 4.8 and 5.5 cm in mucinous cystadenoma, serous cystadenofibroma, serous cystadenoma, simple serous cyst, benign teratoma and borderline tumors respectively.In 102 out of 121 (84.29%) cases, cystectomy was finished without rupture, whereas in 19 women out of 121 (15.7%) women the cyst ruptured. Spillage occurred only in three cases, 2 cases of benign dermoid and one case of serous cystadenoma. Some ovarian cysts ruptured but in the presence of the endoscopic bag, there was no spill of any content in cysts less than 6 cm. But a slight leakage happened although there was great effort to prevent this spill in 3/119 (2.47%) women with cysts more than 6 cm of 2 dermoid and one serous cyst. Conclusion:Proper decision in managing ovarian cysts in very important as when we combine the following factors; the type of the cystic lesion based on ultrasonographic picture with excluding malignant possibility and a mean cyst diameter of less than 6 cm with the use of endoscopic bag gives the best chance for proper excision of ovarian cysts laparoscopically with less possibility for cyst rupture and spillage and even if rupture occurs leakage of cyst contents could be prevented by the endoscopic bag. While larger cysts more than 6 cm or malignant cystic lesions needs more care and are more hard to deal and needs more future researches.