Feasibility and safety of laparoscopic ovarian cystectomy in Iraqi hospital

Background: The use of laparoscopic Ovarian Cystectomy has become more popular over recent years as a minimally invasive option for treating benign gynecological conditions around the world. Limited information is available with respect to how laparoscopic hysterectomies have been performed in Iraq and what patients have experienced when undergoing this type of procedure. Therefore, this study evaluated the feasibility, safety, and clinical outcomes of laparoscopic Ovarian Cystectomy on patients at Al-Hussein Teaching Hospital in Samawah, Iraq. Methods: This was a prospective observational study that included 156 female patients who underwent laparoscopic Ovarian Cystectomy for benign gynecological conditions at Al-Hussein Teaching Hospital from January 2022 to December 2023. The primary outcomes included the following: duration of surgery, estimated blood loss during surgery, rate of complications, number of patients converted to an open abdomen for surgery, and rate of complications following surgery. The secondary outcomes included the length of hospital stay, rate of returning to normal activity after surgery and average satisfaction scores given by patients following their surgery. Results: The average age of the participants was 46.3±6.8 years, and the primary indication for laparoscopic Ovarian Cystectomy were located in the following percentages: uterine fibroids (52.6%), adenomyosis (23.7%), and abnormal uterine bleeding (15.4%). The surgical duration averaged 112.4±28.6 minutes, and the estimated blood loss was approximately 145.3±68.4 mL. Six patients, or 3.8%, underwent laparotomy. Intraoperatively, four patients, or 4.5%, experienced complications, including bladder injury in one (1.9%) patient and vascular injury in one (1.3%) patient. The overall complication rate was 3.2%, while the average number days hospitalized was 2.1±0.6 days, and patient satisfaction score was 8.7/10. Conclusion: The laparoscopic Ovarian Cystectomy can be safely used in the medical setting in Iraq, and the clinical outcomes of laparoscopic Ovarian Cystectomy at the Al-Hussein Teaching Hospital were comparable to international standards. Laparoscopic Ovarian Cystectomy can be used even when limited resources and infrastructure present difficulties for patients with benign gynecological problems requiring a Ovarian Cystectomy.