Laparoscopic management of ovarian cysts

Yat‐May Wong, Saad Amer, Tin Chiu Li, Ian Cooke
In: Gynaecological Endoscopy · 2000 · vol. 9(2) , pp. 79–90 · doi:10.1046/j.1365-2508.2000.00343.x · W2068102185
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This review details laparoscopic techniques for ovarian cyst management, highlighting preoperative assessments, safe removal criteria, and the benefits of cystectomy for endometriomas over drainage and ablation.

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Abstract

Objective To review the various techniques of laparoscopic management of ovarian cysts and specimen retrieval. Design Medline search on topics related to ovarian cysts, ovarian endometrioma, medical and surgical management. Results Transvaginal scanning and measurement of CA 125 level are useful preoperative investigations. The value of preoperative Doppler ultrasound is yet to be established. In the absence of any features of malignancy, ovarian cysts of more than 5 cm may be safely removed laparoscopically. In ovarian endometrioma, drainage followed by ablation of the cyst wall is acceptable, although recent randomized data suggest that cystectomy produces better results. Rupture of stage 1a ovarian carcinoma does not worsen the prognosis if the laparoscopy is converted to laparotomy immediately. Conclusion The optimal outcome of laparoscopic management of ovarian cysts depends on careful patient selection and the ability to remove the cyst intact without spillage of its contents. A timely conversion from laparoscopy to laparotomy in cases of malignancy will not worsen the eventual prognosis.

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endometrioma

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