Laparoscopic Management of Large Ovarian Cysts

Background: Laparoscopy is a novel surgical technique that combines elements of major and minor surgery. The use of ultrasonography (US) and other imaging techniques for abdominal and pelvic examination has led to a rise in the incidence of ovarian cysts seen in female patients who are asymptomatic in recent years. The present study aimed to evaluate the safety, the risks of laparoscopy in management of large ovarian cysts and the possible technical modifications to overcome the difficulties of the procedures. Methods: Twenty patients were included in this study with large ovarian cysts 10 cm; of those twenty patients, laparoscopy was done in 17 cases (85%). Conducted at the Faculty of Medicine Tanta University Hospital. Results: The other three cases were first tried by laparoscopy that was failed and shifted to laparotomy, all of them was previous caesarian section and appendicectomy with dense pelvic adhesions. Laparoscopic management was successful for 17 (85%) women. No complications related to laparoscopy. The operative time of laparoscopically managed ovarian cyst ranged from 35–90 minutes. Six women managed by laparoscopic cystectomy, five women undergone laparoscopic cystotomy and six women had laparoscopic marsupialization. No postoperative complications occurred in laparoscopically managed cases and the length of hospital stay was 12 hours for women who underwent laparoscopy and 1 day for those converted to laparotomy. Conclusions: With good selection of cases and highly skilled operator, laparoscopy is not contraindicated in management of large ovarian cysts.