Abstract
Thirty patients with ovarian dermoid cysts removed by laparoscopic surgery were compared with 42 patients with ovarian dermoid cysts removed by laparotomy, with respect to the selection criteria, surgical procedures, operating time, intraoperative and postoperative complications, blood loss, and hospital stay. Although the operating time for unilateral cystectomy, unilateral salpingo-oophorectomy, and bilateral cystectomy performed by laparoscopic surgery was longer (120.3 ± 43.7 min, mean ± SD) than those for the same procedures performed by laparotomy (73.9 ± 21.6 min, p < 0.01), we observed a learning curve with a remarkable declining tendency (linear regression model, p < 0.01). At the end of this study, the times taken for laparoscopic procedures were almost the same as those for laparotomy. Less blood loss (18.2 ± 1.7 ml versus 105.9 ± 84.3 ml, p < 0.01) and shorter hospital stay (5.9 ± 1.9 days versus 12.0 ± 2.9 days, p < 0.01) were also found to be advantages of laparoscopic surgery. This article discusses the technical procedures of laparoscopic surgery. The efficiency and safety of operative laparoscopy as an alternative access route for the management of ovarian dermoid cysts were recognized. We stress that strict criteria for selection of patients should always be followed and the necessity of retraining schedules for gynecologists and nursing staff in the speciality of laparoscopic surgery.
Highlights
Operative laparoscopy has become one of the most common applications in the management of ovarian cysts
At present the major remaining controversies are the potential risk of malignancy after laparoscopic surgery [6], spillage of the cyst contents, and the potentially prolonged operating time 12]
In this study the mean operating times for the three kinds of laparoscopic procedures were longer than those for the same procedures performed by laparotomy; the mean time for laparoscopic surgery overall was significantly longer than that for laparotomy
Summary
Operative laparoscopy has become one of the most common applications in the management of ovarian cysts. Since almost all laparoscopic research related to ovarian cysts has put the emphasis on the laparoscopic procedure only and paid little attention to its performance in comparison with laparotomy with respect to its advantages and pitfalls in clinical practice, proper evaluation in this regard is urgently required [7]. This retrospective study reviews our experiences in the laparoscopic removal of dermoid cysts over 19 consecutive months, in comparison with laparotomies over the same period. The selection criteria, advantages, and procedures of laparoscopic surgery are discussed
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