Author(s): Gamal H Eltabbakh
Objective To assess the feasibility and surgical outcome of laparoscopic surgery among women with large benign ovarian cysts. Methods We conducted a prospective study applying laparoscopic surgery among women with ovarian cysts whose maximum diameter was ≥10 cm and radiologic and laboratory features suggestive of benign disease. Patients' demographics, clinical and ultrasound features, CA-125 values, surgical procedures, operative and post-operative complications, estimated amount of blood loss (EBL), operative time, conversion to laparotomy and the pathologic findings were recorded. Results Thirty-three consecutive patients underwent laparoscopic surgery over 7 years. The mean (range) age and body mass index were 45.2 (17–73 years) and 30 (21–42), respectively. Laparoscopic surgery was successful in 31 (93.9%) patients. The procedure was converted to laparotomy in 2 patients secondary to adhesions. There were no operative or post-operative complications. The mean (range) operative time, EBL and hospital stay were 82 (45–125 min), 89 (20–250 mL) and 0.94 (0–4 days), respectively. Twenty-three (70%) patients were discharged home the day of the surgery. The surgical procedures performed were: unilateral salpingo-oophorectomy (SO) (n=16), bilateral SO (n=4), ovarian cystectomy (n=2) and laparoscopically assisted vaginal hysterectomy and bilateral SO (n=9). The cysts were extracted after aspiration through the vagina (n=11), lower quadrant incision (n=5) or the umbilical incision (n=15). Pathologic findings included serous cystadenoma (n=11), mucinous cystadenoma (n=6), dermoid (n=6), endometriosis (n=5), benign epithelial-lined cyst (n=3) and borderline ovarian tumors (n=2). Conclusion Laparoscopy is feasible and safe for women with large ovarian cysts with benign features and results in a short hospital stay.