A safe method of deflating ovarian cysts in a bag at laparoscopy

Abstract

ABSTRACTObjective To describe a novel technique to drain a cyst in a bag at laparoscopic oophorectomy/cystectomy to reduce the incidence of bag rupture and intra‐peritoneal spillage of the cyst contents.Setting An undergraduate teaching hospital.Subjects Six women undergoing laparoscopic surgery for ovarian cysts.Design Prospective observational study.Materials and Methods We used the sterile plastic wrapping of the disposable suction/irrigation tubing as the bag. The bag is inserted via the 10 mm camera port by rolling it onto the blunt probe. The specimen is put into the bag either prior to surgery (for ovarian cystectomy) or after excision (for oophorectomy). The opening of the bag is then pulled out through the left ancillary port incision. To drain and debulk the cyst, a blunt probe is put into the bag and a valveless cannula rail‐roaded over the probe. The probe is removed and a Veress needle pushed down the cannula and into the cyst under direct laparoscopic vision. The cyst is drained and the bag removed either via the incision or a posterior colpotomy.Results This technique was used on six patients. In all cases the bag remained intact with no spillage of ovarian contents.Conclusion This technique reduces the chance of cyst content spillage during drainage at laparoscopic oophorectomy/cystectomy while avoiding the need to use expensive disposable laparoscopic bags.