Laparoscopic Ovarian Cystectomy

Cystectomy is a surgical excision of an ovarian cyst. Ovarian cysts are small fluid-filled sacs that develop on the ovaries. Ovaries are the almond shaped organs located one on each side of the uterus. Once a month, during your menstrual cycle, a follicle forms on your ovary. A follicle is a fluid filled sac that contains an egg. Usually a follicle release mature egg from your ovary (ovulation). In some cases, if the follicle fails to rupture and release an egg, the fluid stays in the follicle and forms a cyst. This is called an ovarian cyst. Individuals with ovarian cysts often do not experience any however some women may experience pressure, swelling, pain in the abdomen, pain during intercourse and abnormal or unusually painful periods.

Your doctor may feel the presence of ovarian cyst during a pelvic examination. An ultrasound test may be done to examine the pelvic organs and for diagnosing ovarian cyst. The doctor may perform a blood test to check levels of several hormones including luteinizing hormone (LH), follicle stimulating hormone (FSH), oestradiol and testosterone. The CA-125 blood test is also done to find out if the cyst is cancerous. A pregnancy test may be performed to rule out pregnancy. Cysts can also be detected with other imaging tests such as computed tomography (CT) scan, magnetic resonance imaging (MRI) scan and Doppler flow studies.

Most ovarian cysts will resolve on own without any treatment. Birth control pills may be prescribed to reduce the formation of new ovarian cysts. Surgery is an option if the cyst does not go away, larger in size, or causes pain and also in menopausal women or who are nearing menopause.

Cystectomy is a surgical procedure during which the ovarian cyst is removed either with laparoscopy, or an open surgery. A laparoscopic cystectomy procedure is a minimally invasive surgery during which a laparoscope, a long thin instrument with a camera attached at one end is used. The procedure is usually done under general anaesthesia and a small incision is usually made below the navel. A laparoscope is inserted through this incision to see the inside of your pelvis and abdomen. Carbon dioxide gas is introduced into the abdominal cavity to create more space to work. Your surgeon identifies the cyst through the scope and removes the cyst. This technique is usually used to remove small cysts.

A laparoscopic cystectomy removes only the cyst leaving the ovaries intact. However, if the cyst is too large or connected to ovarian tissue, your surgeon removes all or part of the ovary. Laparotomy is an open surgical exploration of the abdomen to examine the organs of the abdomen. You will be administered general anaesthesia and a single, large cut is made through the abdominal wall. Then the abdominal muscles are separated to reach your ovary. In some cases the blood vessels supplying the ovary are clamped and tied off. Then the cyst is removed. Alternatively, samples of tissues may be removed for further analysis. If the cyst is cancerous, the doctor may need to take out the affected ovary. The abdominal muscles are sewed and the incision is closed with stitches.

Following ovarian cyst removal, complete recovery usually takes about one to two weeks. Your doctor may prescribe anti-inflammatory medications to help relieve your pain.

The specific complications associated with ovarian cyst removal include need for removal of one or both ovaries, injury to the surrounding organs, damage to the fallopian tube/s, damage to womb, and infection.

When you are recommended for a cystectomy, your surgeon decides whether to use a laparoscopic procedure or open surgery.