Laparoscopic management of large ovarian cysts

Abstract

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.