|February 2004 · Vol. 16, No. 2
A novel minilaparotomy approach for large ovarian cysts
This alternative to laparoscopic and laparoscopic-assisted procedures retains the benefits of minimal access while circumventing the need for special equipment, long operating times, and an extended learning curve.
Dr. Pelosi II is director and Dr. Pelosi III is associate director, Pelosi Women’s Medical Center, Bayonne, NJ. Dr. Pelosi II also serves on the OBG Management Board of Editors.
Address correspondence to: Pelosi Women’s Medical Center, 350 Kennedy Boulevard, Bayonne, NJ 07002; telephone: 201-858-1800; fax: 201-858-1002; e-mail: firstname.lastname@example.org.
SUMMARY OF THE TECHNIQUE
Make a cruciate incision by incising the skin transversely and the anterior rectus fascia vertically.
Insert a soft, sleeved, self-retaining retractor.
Using a surgical adhesive, glue a large plastic wound dressing to the surface of the cyst to prevent leakage of contents into the abdominal cavity.
Aspirate the cyst until it collapses and can be delivered, with the ovary, through the abdominal incision.
After performing an extracorporeal cystectomy and/or adnexectomy, return the repaired ovary to the abdominal cavity.
Although laparotomy is still considered the standard for ovarian cyst removal, over the past 15 years minimally invasive surgery has gained wider acceptance in cases where preoperative assessment suggests an adnexal mass is benign.
Unfortunately, minimally invasive management of a large ovarian cyst (greater than 10 cm) is particularly challenging for several reasons: