Abstract
<h3>Study Objective</h3> Minimally invasive approaches are preferred in the surgical management of large ovarian cysts but gaining abdominal access can pose significant challenges for the gynecologic surgeon. Our objective is to review abdominal entry options in women with large ovarian cysts and demonstrate an approach we have successfully used in a recent case at our institution. <h3>Design</h3> N/A. <h3>Setting</h3> OR. <h3>Patients or Participants</h3> 87-year-old G0 female with 20 cm left ovarian cyst, palpated above the umbilicus. <h3>Interventions</h3> laparoscopic LSO for 20 cm ovarian cyst using mini-laparotomy and protector-retractor system for abdominal access. <h3>Measurements and Main Results</h3> N/A. <h3>Conclusion</h3> Combining a mini-laparotomy at the umbilicus using a protector-retractor system allows the gynecologic surgeon to complete most of the procedure laparoscopically. This approach also allows for extra-peritoneal drainage of cyst contents, thereby minimizing intra-peritoneal spillage, as well as for easy specimen removal.
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