LAPROSCOPIC TREATMENT FOR OVARIAN CYSTS
Laparoscopic Ovarian Cystectomy
A surgical removal of cysts on the ovaries through a small keyhole incisions. A cyst is a sac of fluid which develops inside the ovaries, which can be either benign or Malignant (cancerous). Typically, a benign ovarian cyst can be removed leaving the ovaries intact, making the natural conception still possible.
Ovarian cysts has recurrence rate of 35% even after they are surgically removed. If the cysts keeps recurring, then the entire ovary is removed by a procedure called Laparoscopic oophorectomy. And also if the cyst is malignant, the entire ovary or both ovaries needs to be removed.
TYPES OF OVARIAN CYST
1. Functional Cysts:Two types are follicular cysts and corpus luteal cysts. These cysts will often shrink and disappear within two or three menstrual cycles.
2. Dermoid Cysts:Also called teratomas, these can contain tissue, such as hair, skin or teeth, because they form from embryonic cells. They’re rarely cancerous.
3. Endometrioma Cysts:These cysts are also known as the “chocolate cysts”. These develop as a result of a condition in which uterine endometrial cells grow outside your uterus (endometriosis). Some of the tissue can attach to your ovary and form a growth.
4. Cystadenoma Cysts:These develop on the surface of an ovary and might be filled with a watery or a mucous material.
5. Polycystic Ovarian Disease:This disease, also commonly known as PCOS, refers to cysts that form from a build-up of follicles. They cause the ovaries to enlarge and create a thick outer covering, which may prevent ovulation from occurring. They are often the cause of fertility problems.
Symptoms of Ovarian Cysts
Most ovarian cysts are small and don’t cause symptoms. If a cyst does cause symptoms, you may have pressure, bloating, swelling, or pain in the lower abdomen on the side of the cyst. This pain may be sharp or dull and may come and go.
If a cyst ruptures, it can cause sudden, severe pain. If a cyst causes twisting of an ovary, you may have pain along with nausea and vomiting.
Less common symptoms include:
1. Pelvic pain
2. Dull ache in the lower back and thighs
3. Problems emptying the bladder or bowel completely
4. Pain during sex
5. Unexplained weight gain
6. Unusual (not normal) vaginal bleeding
7. Breast tenderness
8. Needing to urinate more often
1. Ovarian torsion. Cysts that enlarge can cause the ovary to move, increasing the chance of painful twisting of your ovary (ovarian torsion). Symptoms can include an abrupt onset of severe pelvic pain, nausea and vomiting. Ovarian torsion can also decrease or stop blood flow to the ovaries.
2. Rupture. A cyst that ruptures can cause severe pain and internal bleeding. The larger the cyst, the greater the risk of rupture. Vigorous activity that affects the pelvis, such as vaginal intercourse, also increases the risk.
Ovarian cysts are fairly common. Most cysts are not harmful and usually resolve on their own. However, some cysts can hinder fertility, cause symptoms, or become cancerous.
Laparoscopic Ovarian Cystectomy may be recommended if:
1. The patient has cysts or other masses in both ovaries
2. An ovarian cyst has not shrunk or disappeared after 3 months
3. A cyst is larger than 3 inches in diameter
4. A cyst appears to be abnormal or malignant
5. Your doctor suspects ovarian cancer
In this procedure, the doctor makes a few small incisions in the abdomen, and inserts the laparoscope. It is a thin, flexible instrument with a lighted camera at the end, which guides the surgeon through the procedure. The tissue is removed with an endobag through these small incisions.
Any investigations or consultations arranged at the preoperative consultation should have been completed, to make sure there are no medical conditions that may cause a problem during the surgery. Patients should not eat or drink anything after midnight on the night before surgery. The bowel preparation medication should be taken as ordered. You should continue your regular medications, unless advised otherwise. Should you develop an illness prior to your surgery, please contact your surgeon immediately.
Unless otherwise specified, you should stop eating and drinking at the following times on the day of the surgery:
1. At midnight for a morning procedure or
2. At 6 am for an afternoon procedure
You should continue all your usual medications, unless otherwise specified.
Patients are put to sleep under general anaesthesia.
95% of our patients go home the same day as their surgery.
When you wake from the anaesthetic, you will be in the recovery room. A drip will be maintained and the catheter will normally be removed the same day.
Patients should expect to take antibiotics and painkillers for a few days post-operatively. We encourage patients NOT to stay in bed. They should move around the house and resume normal activities as soon as they feel up to it. Some women are well enough to return to work 5 days after surgery.
1. Eat and drink normally
2. Remain mobile
3. Shower normally