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Objectives. Huge ovarian cysts are conventionally managed by laparotomy. We present 5 cases with huge ovarian cysts managed by laparoscopic endoscopic surgery without any complications. Materials and Methods. We describe five patients who had their surgeries conducted in a tertiary care center in Riyadh, Saudi Arabia (King Fahad Medical City). Results. Patients age ranged between 19 and 69 years. Tumor markers were normal for all patients. The maximum diameter of all cysts ranged between 18 and 42 cm as measured by ultrasound. The cysts were unilocular; in some patients, there were fine septations. All patients had open-entry laparoscopy. After evaluation of the cyst capsule, the cysts were drained under laparoscopic guidance, 1–12 liters were drained from the cysts (mean 5.2 L), and then laparoscopic oophorectomy was done. The final histopathology reports confirmed benign serous cystadenoma in four patients and one patient had a benign mucinous cystadenoma. There was minimal blood loss during surgeries and with no complications for all patients. Conclusion. There is still no consensus for the size limitation of ovarian cysts decided to be a contraindication for laparoscopic management. With advancing techniques, proper patients selection, and availability of experts in gynecologic endoscopy, it is possible to remove giant cyst by laparoscopy.

Objectives. Huge ovarian cysts are conventionally managed by laparotomy. We present 5 cases with huge ovarian cysts managed by laparoscopic endoscopic surgery without any complications. Materials and Methods. We describe five patients who had their surgeries conducted in a tertiary care center in Riyadh, Saudi Arabia (King Fahad Medical City). Results. Patients age ranged between 19 and 69 years. Tumor markers were normal for all patients. The maximum diameter of all cysts ranged between 18 and 42 cm as measured by ultrasound. The cysts were unilocular; in some patients, there were fine septations. All patients had open-entry laparoscopy. After evaluation of the cyst capsule, the cysts were drained under laparoscopic guidance, 1-12 liters were drained from the cysts (mean 5.2 L), and then laparoscopic oophorectomy was done. The final histopathology reports confirmed benign serous cystadenoma in four patients and one patient had a benign mucinous cystadenoma. There was minimal blood loss during surgeries and with no complications for all patients. Conclusion. There is still no consensus for the size limitation of ovarian cysts decided to be a contraindication for laparoscopic management. With advancing techniques, proper patients selection, and availability of experts in gynecologic endoscopy, it is possible to remove giant cyst by laparoscopy.

We report a patient with primary infertility and clinical manifestation of premature ovarian insufficiency (POI) who upon investigation was found to have streak ovaries, and genetic testing revealed Trisomy X (47, XXX). Therefore, we suggest for genetic testing in women with POI to detect common aneuploidies for better counseling and treatment.

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BACKGROUND AND OBJECTIVE:Myomectomy is considered a highly morbid procedure due to the risk of high intraoperative blood loss. Meticulous surgical techniques can reduce operative morbidity. Our aim was to evaluate and compare the intraoperative blood loss between two surgical techniques: 1) the uterine vascular cutoff technique and 2) the classical technique.DESIGN AND SETTING:Retrospective chart review conducted between 1 July 2008 until 30 June 2010 in a tertiary care referral center to compare surgical outcomes of two groups.PATIENTS AND METHODS:The sample included 136 patients: 30 patients had their surgeries performed with the uterine vascular cutoff technique, and the remainder (106 patients) had myomectomies performed with the classical technique. The uterine vascular cutoff technique was performed by the same surgeon for all 30 patients, whereas myomectomy with the classical technique was performed by several gynecologists.RESULTS:There was no significant difference between the two groups in parity and operation time; however, patients in the first group had a statistically significant higher mean age (39.1 [7.6] vs 35.8 [6.9] years; P=.025) and, on average, bigger fibroid size by gestational week (20.1 [7.3] vs 17 [5.2] weeks; P=.0094), with standard deviation shown in parentheses. There was a statistically significant lesser drop in hemoglobin concentration among patients in the first group (1.23 [1.2] vs 2.25 [1.4] g/dL; P=.0003), and the postoperative hemoglobin was significantly higher in the first group (10.5 [1.6] vs 9.7 [1.7] g/dL; P=.036). The hospital stay was shorter for patients in the first group (5.8 [1.7] vs 7.1 [2.9] days; P=.031).CONCLUSION:The vascular cutoff technique leads to less intraoperative blood loss without increasing the operative time, patients tolerate this technique very well, and the technique is associated with shorter hospital stay, all of which could contribute to less postoperative morbidity.

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