Endoscopic surgery for mature teratoma of the ovary

Ulrich, U.; Keckstein, J.; Paulus, Wolfgang; Sasse, V.

doi:10.1007/bf00188479

Cited by 14 publications

(8 citation statements)

References 18 publications

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“…In fact the mean operative time in our experience (64 min) is similar to that reported by Volz et al [10], who used a similar technique, and by Yuen and Rogers [20] (60 min) and Morgante et al [58] (57 min) for open surgery and by Pardi et al [42] for laparoscopy-assisted vaginal removal, but it was lower than what was reported by other authors for laparotomy [18,21,22] or laparoscopy (table 2), [8,9,12,18,19,20,21,22,26,27,29,33,34,36,37,39,40]. Our mean surgical time is also lower than that reported by Ferrari et al [38] or Wang et al [44] for the direct vaginal approach (81 and 78 min, respectively).…”

Section: Discussioncontrasting

confidence: 46%

“…Most benign teratomas are asymptomatic [4,12,13]. In the present series, teratomas were diagnosed by ultrasound and gynecological examination in 23 asymptomatic patients; only 12 patients reported pelvic pain.…”

Section: Discussionmentioning

confidence: 81%

“…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%).…”

Section: Discussionmentioning

confidence: 99%

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A Modified Technique to Reduce Spillage and Operative Time: Laparoscopic Ovarian Dermoid Cyst Enucleation ‘in a Bag’

Campo

2010

Gynecol Obstet Invest

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Background: To describe the outcomes of a modified technique for conservative laparoscopic enucleation of ovarian dermoid cyst, placing the ovary in an endobag during enucleation to prevent intraperitoneal spillage. Methods: Laparoscopic dermoid cyst enucleation was performed in 35 cases of premenopausal patients placing the ovary in an endobag at the beginning of the procedure and removing the cyst from the abdominal cavity by the same endobag. Results: Dermoid cysts with a mean diameter of 6.3 ± 2.7 cm were enucleated and removed laparoscopically ‘in a bag’ without intra- or postoperative complications. Cyst rupture occurred in 10 cases (28.5%), but evident peritoneal contamination occurred in only 2 (5.7%; 95% confidence interval: 0.7–19.2%), because in 8 patients spillage was contained by the surrounding bag. The mean operative time was 64.6 ± 27 min. No signs or symptoms of peritonitis were observed. The mean postoperative hospitalization was 1.6 ± 1.4 days. Among the 12 infertile patients, 7 spontaneous pregnancies (58%) occurred. Conclusions: Laparoscopic conservative excision of dermoid cysts placing the ovary in an endobag at the beginning of surgery and removing the cyst by the same bag is a safe and effective approach to reduce intraperitoneal spillage and operative time.

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Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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A Modified Technique to Reduce Spillage and Operative Time: Laparoscopic Ovarian Dermoid Cyst Enucleation ‘in a Bag’

Campo

2010

Gynecol Obstet Invest

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“… 5 – 7 The management of a dermoid cyst therefore depends more on its symptoms and clinical findings than the very small risk of actual malignancy. 8 , 9 A decision can then be made between conservative management, laparoscopic surgery or laparotomy depending upon the patients’ symptoms, age, clinical findings and ultrasonographic features. 10 …”

mentioning

confidence: 99%

Laparoscopic management of ovarian dermoid cysts: a review of 47 cases

Koçak

Dilbaz

Öztürk

et al. 2004

Annals of Saudi Medicine

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BackgroundMature cystic teratomas, often referred to as dermoid cysts, are the most common germ cell tumors of the ovary. In the recent years, transvaginal sonographic diagnosis of ovarian dermoid cysts together with laparoscopic approach have greatly improved the treatment of this benign lesion. We retrospectively reviewed the outcome of laparoscopic surgery for suspected ovarian dermoid cysts.Patients and MethodsThe preoperative findings, operative techniques and post-operative complications were retrospectively reviewed in women who underwent laparoscopic surgery for dermoid cysts, between January 2000 and May 2003.ResultsIn 47 women aged 21 to 53 years (median, 38.8 years), 93.6% had a unilateral cyst with a diameter of 17 to 108 mm (median, 51 mm). Clinical presentations were pain (62%), abnormal vaginal bleeding (21%) and ovarian torsion (2%), whilst 17% were diagnosed incidentally during routine examination. Surgery included cystectomy (57%), total (36%) or partial oophorectomy (6.4%) and laparoscopy-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy (2%). During the cyst extraction, minimal spillage occurred in 42.5% of the cases and none developed chemical peritonitis. In 2 patients, conversion to laparotomy (4.3%) was required, one for sigmoid colon injury and one for malignant ovarian tumor detected via frozen section. The median operating time was 80 minutes (range, 35–180 minutes).ConclusionUsing strict adherence to guidelines for preoperative clinical assessment and intra-operative management, laparoscopic treatment of dermoid cysts appears to be a safe procedure.

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“…The rate of rupture during laparoscopy is very high in MCTs. Approximately 54% has been detected ( 21 , 22 , 23 ) . The probability of rupture has been found to be independent of size and location of MCT ( 24 , 25 ) .…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of mature cystic teratomas in a single center and review of the literature

Abide

Ergen

2018

tjod

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Objective:The aim af this study is to evaluate patients with mature cystic teratomas (MCT) with regard to the view of updated knowledge using our retrospective findings.Materials and Methods:This was a retrospective study and included a total of 306 patients from 2013 through 2017 at the İstanbul Zeynep Kamil Women and Children’s Diseases Training and Research Hospital.Results:The mean age of the patients was 34.03±11.98 years. Thirty (9.8%) patients were postmenopausal. Torsion was detected in 17 (5.6%) patients. There was a statistically significant relationship between MCT and CA 19-9 levels in our series (p<0.01) but no statistically significant correlation was found with other markers.Conclusion:The possibility of malignancy at postmenopausal ages and in large MCT should not be forgotten. It should be kept in mind that MCT can be seen in unexpected places.

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Endoscopic surgery for mature teratoma of the ovary

Abstract: Our findings confirm those of other authors- when performed by experienced surgeons, laparoscopic removal of ovarian mature teratomas is a safe and recommendable alternative to laparotomy. Preoperative diagnosis and intraoperative inspection of the tumor must be as thorough as possible.

Cited by 14 publications

References 18 publications

A Modified Technique to Reduce Spillage and Operative Time: Laparoscopic Ovarian Dermoid Cyst Enucleation ‘in a Bag’

A Modified Technique to Reduce Spillage and Operative Time: Laparoscopic Ovarian Dermoid Cyst Enucleation ‘in a Bag’

Laparoscopic management of ovarian dermoid cysts: a review of 47 cases

Retrospective analysis of mature cystic teratomas in a single center and review of the literature

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