Laparoscopic Cystectomy: When is it needed?

 

What is an ovarian cyst?

An ovarian cyst is a fluid-filled sac that develops in an ovary.

The ovaries are two small, bean-shaped organs – one each side of uterus. The ovaries release an egg every month as part of the menstrual cycle. During this time, small, fluid-filled sacs (follicles) form. The follicle ruptures to release an egg. If the fluid-filled sac becomes large, or doesn’t rupture, it is called a cyst.

Ovarian cysts are common and many women may be unaware they have one. They may disappear by themselves without treatment. They may affect one or both ovaries

Symptoms of an ovarian cyst

  • Lower abdominal or pelvic pain

  • Painful periods or change in pattern of periods

  • Pain during sex

  • Painful bowel movement

  • Urinary symptoms

  • Bloated abdomen

  • Difficulty in conceiving

Types of ovarian cysts

  • Simple

  • Complex (with blood, different types of tissues or solid areas)

  • Endometriotic (Chocolate)

All about the surgery

 

Why do I need surgery?

Surgery is usually recommended if you have symptoms that are thought to be caused by the cyst, if the cyst is large or has any features which may suggest a possibility of it being cancerous. A cyst which has twisted or ruptured will also need surgery. Your doctor will explain the reason as to why surgery has been recommended. Feel free to bring forward any doubts which you might have or your options other than surgery.

What does the operation involve?

The operation is performed under general anaesthesia. The operation involves a cut just above the umbilicus (belly button). A needle is inserted through here to fill the abdominal cavity with carbon dioxide. A telescope is used to look inside the abdomen. 2-3 further cuts are made on your lower abdomen. These are usually less than a centimeter long. It may sometimes be necessary to change the location of cuts or make additional ones, especially if you have had surgery before and there is a possibility of adhesions. Ports are put in through these cuts to introduce the instruments.

A cut is made on the surface of the cyst. The cyst is peeled away from the remaining healthy ovary. Any bleeding after removal of the cyst is controlled using heat energy or sutures. The cyst is removed through one of the ports and sent to the lab for microscopic examination for final diagnosis. Sometimes, removing the ovary might be more feasible than removing just the cyst (suspicion of malignancy, recurrent cysts, post menopausal women).

The surgeon will carefully check for any bleeding before evacuating gas from your abdomen. The wound sites will then be closed by stitches, staples or glue.