Combined laparoscopic treatment of polycystic ovary disease and gallstones

Abstract

Laparoscopic surgery has largely replaced laparotomy in the management of both polycystic ovary disease (PCOD) and gallstones. The number of patients with a combination of these disorders has increased. From 1991 to 1996, 908 patients underwent laparoscopic cholecystectomy. In 29 women of reproductive age (18-41 yrs) with PCOD and gallstones, we performed combined laparoscopic cholecystectomy and various procedures on the ovaries (15 wedge resections, 8 multiple ovariotomies by thermocoagulation incisions, 5 electrosurgical coagulations of the ovaries). All operations were performed by the usual approach for laparoscopic cholecystectomy, and in only four women did we place a supplemental cannula. The diagnosis of PCOD was established preoperatively in 22 women, but in 6 it was an incidental finding during laparoscopic inspection of abdominal cavity. We suggest that one-stage laparoscopic cholecystectomy and procedures on the ovaries may be performed with single-puncture technique. Performing the procedures simultaneously has the advantages of minor surgical trauma, much less adhesion formation, and ability to treat hormonal disorders and infertility. For best results in women with combined PCOD and gallstones, the joint participation of abdominal surgeon and gynecologist is preferred.