Large Ovarian Cyst

I had a very interesting surgery a little while ago. I had a elderly woman who was referred with a large, complex, cystic mass on her ovary. After my discussion with her, she chose to have an evaluation through the laparoscope with possible removal of the ovary.

At the time of surgery, her ovary was noted to be free, without adhesions, and with a smooth surface. She did have multiple cysts on the ovary. The largest cyst was about 15 centimeters in size. Because there were no adhesions, no abnormal fluid within her abdomen, and no concerning features on the surface of the ovary, I elected to drain the cyst and removed the ovary laparoscopically.

A 5 millimeter incision was made just above the pubic bone. A small tube was inserted through this incision and into the cyst. A suture was placed around the cyst and tube and the cyst was then drained. As the cyst collapsed, the suture was tightened around the cyst to prevent spilling.

After the largest cyst was drained, I was able to remove the ovary and place it inside a sterile, plastic bag. Once contained within the plastic bag, the opening of the bag was brought through the 2 centimeter incision in her belly button. The cyst was then removed through that small incision.

The patient went home the same day and two days later was feeling well and off of pain medication.

In appropriate patients, laparoscopy can be safely used to treat cysts and masses of the ovaries and fallopian tubes. Even large masses such as described above can be managed with the benefits of minimally invasive, laparoscopic surgery.

Dermoid Ovarian Cyst

Recently I had a patient that presented with a 4-5 centimeter ovarian cyst. Her initial complaint with this cyst was severe, intermittent pelvic pain. On ultrasound examination, she had a complex, solid and cystic, mass on her ovary. There was a high suspicion of what is called a "Dermoid Cyst".

Dermoid cysts are very interesting in that they can have many cell types within them. They have been known to grow an oily, sebaceous material, hair, teeth and other strange and interesting things to find in an ovary. They are very rarely of a malignant type which include nerve type tissue.

This patient elected to have her entire ovary removed although it would have been feasible to remove only the cyst itself. Either of these surgeries can be performed easily with a laparoscopic surgery.

As always if you have questions, please feel free to send me an email. You can find it under my profile link.