Abstract
Objectives. Huge ovarian cysts are conventionally managed by laparotomy. We present 5 cases with huge ovarian cysts managed by laparoscopic endoscopic surgery without any complications. Materials and Methods. We describe five patients who had their surgeries conducted in a tertiary care center in Riyadh, Saudi Arabia (King Fahad Medical City). Results. Patients age ranged between 19 and 69 years. Tumor markers were normal for all patients. The maximum diameter of all cysts ranged between 18 and 42 cm as measured by ultrasound. The cysts were unilocular; in some patients, there were fine septations. All patients had open-entry laparoscopy. After evaluation of the cyst capsule, the cysts were drained under laparoscopic guidance, 1–12 liters were drained from the cysts (mean 5.2 L), and then laparoscopic oophorectomy was done. The final histopathology reports confirmed benign serous cystadenoma in four patients and one patient had a benign mucinous cystadenoma. There was minimal blood loss during surgeries and with no complications for all patients. Conclusion. There is still no consensus for the size limitation of ovarian cysts decided to be a contraindication for laparoscopic management. With advancing techniques, proper patients selection, and availability of experts in gynecologic endoscopy, it is possible to remove giant cyst by laparoscopy.
Highlights
Ovarian neoplasms are a common clinical problem affecting women of all age groups
The aim of our study is to evaluate the safety, effectiveness, and feasibility of operative laparoscopy in the management of huge ovarian cysts reaching above the umbilicus
Physical examination, and radiological findings were in favour of a benign nature of the cysts, the patient would be selected for endoscopic approach
Summary
Ovarian neoplasms are a common clinical problem affecting women of all age groups. They are the fourth most common reason for gynecologic admission in the United States, and it has been estimated that approximately 10% of women in the United States will undergo surgical procedure for a suspected ovarian neoplasm during their lifetime [1].Laparoscopy is considered the gold standard approach to manage benign ovarian cysts. Ovarian neoplasms are a common clinical problem affecting women of all age groups. They are the fourth most common reason for gynecologic admission in the United States, and it has been estimated that approximately 10% of women in the United States will undergo surgical procedure for a suspected ovarian neoplasm during their lifetime [1]. Laparoscopy is considered the gold standard approach to manage benign ovarian cysts. Some authors define large ovarian cysts as those that are more than 10 cm in diameter as measured by preoperative scans [2]. Others define large ovarian cysts as those that are reaching above the umbilicus [3]
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