Effectiveness and strategies of Laparoscopic Assisted Cystectomy for benign large ovarian cysts

Objective We evaluated the effectiveness of Laparoscopically Assisted Cystectomy (LAC) for benign large ovarian cysts.

Materials Benign ovarian cysts can become huge above the umbilicus even in younger women including teenagers. Laparotomy with a large vertical wound used to be performed for large ovarian cysts reaching epigastrium or large endometrial ovarian cysts with severe adhesion, which is very physically and esthetically invasive. We perform LAC at our facility with two ports for preoperatively benign ovarian cysts regardless of cyst size. In case of endometriosis, we choose Total Laparoscopic Cystectomy to separate the adhesion. However, in cases of large endometrial ovarian cysts with severe adhesion, we choose LAC with three or four ports to preserve the surgical space for adhesiotomy.

Methods We evaluated LAC cases at our facility between January 1st, 2008 and December 31st, 2019 in terms of cyst size, amount of cyst content, operating time, amount of bleeding, length of postoperative stay, complications, and pathology. We compared between the two groups of huge ovarian cysts reaching epigastrium and smaller ovarian cysts reaching around promontory, and validated the effectiveness of LAC.

Results There were significant differences between the two groups in cyst size and cyst content, but there were no significant differences in operating time, amount of bleeding, length of postoperative stay, and complications. Both groups showed the same variety of pathologies including endometriosis with severe adhesion.

Summary LAC for preoperatively benign large ovarian cysts is physically and esthetically very effective operative method for young women regardless of its pathology.

Publication History

Article published online:
07 October 2020