Laparoscopic Ovarian Cystectomy

What is Laparoscopic Ovarian Cystectomy

Laparoscopic ovarian cystectomy is a surgical procedure to remove cysts from the ovaries laparoscopically.

What is Laparoscopy

Laparoscopy, also known as keyhole surgery or minimally invasive surgery, is a surgical procedure that uses a laparoscope, a flexible fiber-optic lighted instrument attached with a camera. The laparoscope is introduced into the abdomen or pelvis through few small keyhole incisions along with tiny specialized instruments to visualize, diagnose, and repair abnormalities.

What are Ovarian Cysts?

Ovarian cysts are small fluid-filled sacs that develop on the ovaries. Ovaries are 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, the follicle releases a 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.

Symptoms of Ovarian Cyst

You may experience pressure, swelling, pain in the abdomen, pain during intercourse, and abnormal or unusually painful periods with ovarian cysts.

How are Ovarian Cysts Diagnosed?

Your doctor may feel the presence of an ovarian cyst during a pelvic examination. An ultrasound test may be performed to examine the pelvic organs and diagnose an ovarian cyst. Your doctor may perform a blood test to check the levels of certain hormones such as the luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, and testosterone. A CA-125 blood test may also be done to find out if the cyst is cancerous. A pregnancy test may be performed to rule out pregnancy. Other imaging tests such as computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, and Doppler flow studies can also help detect ovarian cysts.

Treatment for Ovarian Cysts

Most ovarian cysts resolve on their 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, grows larger in size or causes pain in menopausal women or those nearing menopause.

Cystectomy is a surgical procedure during which the ovarian cyst is removed either with laparoscopy or open surgery. Your surgeon will decide whether to use a laparoscopic procedure or open surgery depending on your condition.

  • Procedure for Laparoscopic Ovarian Cystectomy: 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 anesthesia and a small incision is made below your navel. A laparoscope is inserted through this incision to look inside 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 it with small surgical instruments inserted through other small incisions. This technique is usually used to remove small cysts, leaving the ovaries intact.
  • Procedure for Laparotomy or Open Surgery: If the cysts are too large or connected to ovarian tissue, your surgeon may opt for an open surgery approach to remove 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 anesthesia and a single, large cut is made through the abdominal wall. The abdominal muscles are separated to reach your ovary. In some cases, the blood vessels supplying the ovary are clamped and tied off and then the cyst is removed. Alternatively, samples of tissues may be removed for further analysis. If the cyst is cancerous, your doctor may need to take out the affected ovary. Finally, the abdominal muscles are sewed, and the incision is closed with stitches.

Postoperative Care

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. You need to avoid strenuous activity or exercise for about a week. Your doctor will also provide you with instructions on incision site care, diet, driving, bathing, etc., as part of the recovery plan.

Complications of Laparoscopic Ovarian Cystectomy

The specific complications associated with ovarian cyst removal include:

  • The need for removal of one or both ovaries
  • Injury to the surrounding organs
  • Damage to the fallopian tube(s)
  • Damage to the womb
  • Infection
  • Anesthetic problems
  • Deep vein thrombosis or blood clots

Advantages of Laparoscopic Ovarian Cystectomy over Open Surgery

The advantages of laparoscopy over traditional open surgery include:

  • Minimal pain and bleeding
  • Shorter hospital stay
  • Faster recovery time
  • Reduced scarring
  • Reduced risk of infection
  • Minimal damage to surrounding tissues
  • Small surgical cuts

What if I Experience Any Issues During the Recovery Period?

You should seek immediate medical attention if you experience any of these conditions:

  • Severe pain that does not get better with pain medicine
  • Redness, swelling, or pus at the incision site
  • An upset stomach or vomiting
  • A fever higher than 101-degree Fahrenheit
  • Heavy bleeding from the incision site or vagina
  • ACOG
  • AIUM
  • American Association of Gynecologic Laparoscopists
  • NYU langone Medical center
  • American Association for Accreditation of Ambulatory Surgery Facilities
  • UpToDate