Conventional Laparoscopic Cystectomy Research Articles

Our laparoscopic cystectomy experiences.

We aimed to present our laparoscopic cystectomy experience and demonstrate that it is a feasible technique with safe oncologic principles. Total 19 patients who underwent laparoscopic radical cystectomy and pelvic lymph node dissection (PLND) in our urology clinic (Okmeydani Training and Research Hospital) were retrospectively evaluated. Demographic data, operation technique and complications, tumour pathology and follow-up details of patients were recorded. Patients ranged from 40 to 73 years, with the average age of 60.8 and female/male rate was 2/17. The mean total operation time was 375 min (range 260-500). Mean hospitalisation time of patients was 10.3 days. The mean follow-up time was 11.2 months. Minimally invasive approaches in urology are becoming the first line treatment by the time. Due to the high costs and limited availability, robotic surgery is still not exactly widespread in the world. Our series showed that conventional laparoscopic cystectomy is an appropriate approach until robotic surgery becomes widespread.

Comparison of the impact of single-port laparoscopic and conventional laparoscopic ovarian cystectomy on the ovarian reserve in adult patients with benign ovarian cysts

Objective: The surgical approach, hemostatic approach, histologic findings, and cyst size and location may have a role in reducing the ovarian reserve. The aim of this study was to investigate the impact of single-port laparoscopic cystectomy (SLC) and conventional laparoscopic cystectomy (CLC) on the ovarian reserve based on serum anti-Mullerian hormone (AMH) concentrations.Material and methods: This non-randomized concurrent control trial enrolled 79 female patients aged 18–45 years with benign ovarian cysts, including 47 patients in the SLC group and 32 patients in the CLC group. Outcome measures, including hospital stay, operative time, blood loss, analgesic use, body temperature, hospitalization cost, and serum AMH concentration, were evaluated preoperatively, two to three days postoperatively, and four to six weeks postoperatively.Results: The reduction in the AMH concentration after cystectomy was significantly different preoperatively, two to three days postoperatively (p < .001), and four weeks postoperatively (p < .001) regardless of the surgical approach (SLC or CLC) [F (1.00,31.00) = 0.026, p = .873]. Moreover, the hemostatic approach and histologic findings yielded significant differences in the serum AMH concentration regardless of the surgical approach (p < .05). The serum AMH concentration was higher in unilateral cysts (2.70 ± 1.80 ng/mL) than in bilateral cysts (1.73 ± 1.11 ng/mL) postoperatively (p < .05). In the SLC group, the serum AMH concentration in the patients with ovarian endometriomas (1.58 ± 1.39 ng/mL) was significantly lower than that in the patients with other cysts (3.22 ± 1.68 ng/mL) postoperatively (p < .05).Conclusion: The serum AMH concentration decreased over time postoperatively but did not significantly differ between SLC and CLC.

Single-port compared with conventional laparoscopic cystectomy for ovarian dermoid cysts

ObjectiveWe compared the immediate surgical outcomes of single-port laparoscopic cystectomy (SLC) and conventional laparoscopic cystectomy (CLC) for managing ovarian dermoid cysts. Materials and methodsA retrospective case-control study was conducted to enroll 71 patients with dermoid cysts, including 34 patients in the SLC group and 37 patients in the CLC group. The outcome measures included operative time, blood loss, postoperative pain, analgesic use, and serum levels of hormones, including estrogen (E2), follicle-stimulating hormone, luteinizing hormone, and anti-Mullerian hormone. ResultsSLC was associated with less time required for specimen retrieval (1.3 ± 0.8 vs. 12.0 ± 3.4 minutes, p < 0.001), fewer ruptured bags (0% vs. 10.8%, p = 0.049), and less need of additional wound elongation (0% vs. 27.0%, p = 0.001) when respectively compared with CLC. Additionally, patients who underwent SLC reported lower postoperative lower abdominal pain and less accumulated postoperative analgesics when respectively compared with patients who underwent CLC. There was no significant difference of hormones between two groups. ConclusionOur study demonstrated the feasibility of using the single-port method in place of CLC in the management of ovarian dermoid without increased difficulty of techniques or risk of ovarian damage.

A comparative study of laparoscopy and colpotomy for the removal of ovarian dermoid cysts

To compare laparoscope-assisted transvaginal removal of dermoid cysts to more standard laparoscopic cystectomy techniques. We conducted a retrospective review of 44 laparoscopic dermoid removals performed at Olive View-UCLA Medical Center between 1992 and 1995. Cases were divided into three groups based on surgical approach: 1) conventional laparoscopic ovarian cystectomy, 2) laparoscopic ovarian cystectomy and removal of the freed mass via colpotomy, and 3) laparoscopic inspection, then transvaginal cystectomy via colpotomy. Surgical time, estimated blood loss, cyst spillage, and complications were compared. There were 11-19 patients in each group. The groups were similar in patient age, parity, and weight. Larger cysts tended to be removed by the laparoscopy-colpotomy techniques (mean diameter 10 cm) rather than by the purely laparoscopic approach (mean diameter 7 cm, P < .05). Cyst spillage occurred less often (43%, P < .05) and surgical time was shortest (mean 81 minutes, P < .05) with laparoscope-assisted transvaginal ovarian cystectomy compared with conventional laparoscopic techniques. Disposable laparoscopic instruments were used less often with transvaginal cystectomy (7%) than with conventional laparoscopic cystectomy (77%, P < .01). The difference in mean estimated blood loss in the cases using colpotomy (89 mL) compared with cases that did not (65 mL) was not statistically significant. Among the three groups, there were four major operative complications related to blood loss and infection. Laparoscope-assisted transvaginal ovarian cystectomy allows the removal of larger dermoid cysts, with less cyst spillage and savings in operative time and equipment compared with conventional laparoscopic cystectomy.