What Is A Laparoscopic Ovarian Cystectomy?

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A laparoscopic ovarian cystectomy is surgery to remove a cyst from your ovary using a laparoscope. Surgeons prefer laparoscopic ovarian cystectomy because it is minimally invasive and easier for you to recover from than open surgery. 

Treatment options depend on your symptoms, age and the type and size of your cyst. Your healthcare provider may recommend an ovarian cystectomy if you have an ovarian cyst that does not go away, gets larger or causes pain. Surgery can often be done using minimally invasive surgery with a laparoscope. However, if the cyst is large or cancer is a concern, an open abdominal procedure using a larger cut may be necessary.


What Are Ovarian Cysts?

The ovaries are small organs in the pelvis that contain egg cells/ ovum and produce hormones, such as oestrogen and progesterone. An ovarian cyst is a fluid-filled sac in an ovary or on its surface. Ovarian cysts are fairly common and often go away on their own without treatment.

Ovarian cysts, which can contain either fluid or semisolid material, can develop on or within one or both of your ovaries. Cyst that develops after menopause may occasionally be cancerous. In this case, you may need to undergo a hysterectomy.

Cysts usually form when a follicle does not dissolve or burst after the release of an egg. The fluid remaining inside the follicle may produce a cyst on the ovary. Although most cysts are linked to the normal function of your menstrual cycle, some cysts (called pathological cysts) develop because of abnormal cell growth. It is normally recommended to remove these types of cysts.


What Causes Ovarian Cysts?

It is very common for women to develop ovarian cysts while of child-bearing age. These cysts, which are related to the hormonal fluctuations of the menstrual cycle, usually disappear by themselves. There are, however, some conditions that can also cause ovarian cysts. These include:


  • Endometriosis - this occurs when pieces of the tissue that line the uterus (endometrium) are found outside the uterus in the fallopian tubes, ovaries, bladder, bowel, vagina or rectum.
  • Polycystic ovary syndrome (PCOS) – this condition causes lots of small, benign (harmless) cysts to develop on the ovaries.
  • Pelvic inflammatory disease (PID) – people with this disease are more likely to develop infected ovarian cysts. This infection of the pelvic area is usually caused by gonorrhoea or chlamydia.
  • Cancer – cancerous ovarian cysts are most common in post-menopausal women.

Who Can Get a Laparoscopic Ovarian Cystectomy?

Laparoscopic surgery might be advised when more conservative treatments cannot effectively remove a cyst. These non-invasive treatments include watchful waiting (waiting to see if the cyst disappears after a few months) and hormonal therapies.

You might need surgery if:

  • The cyst is large (6 – 10cm in diameter)
  • You have pain
  • The cyst may be cancerous

How Is A Laparoscopic Ovarian Cystectomy Performed?

Preparing for Laparoscopic Ovarian Cystectomy

Before the procedure, general anaesthesia is administered, and an intravenous (IV) catheter is inserted. Following prepping, the surgeon initiates the surgery.


Laparoscopic Procedure Steps

A laparoscope, a slender, illuminated instrument, is inserted through a small incision near the belly button to visualize reproductive and pelvic organs. Carbon dioxide is used to inflate the abdomen, facilitating optimal organ visibility and instrument manoeuvrability.

Additional small incisions are made for surgical tool insertion. The ovarian cyst is excised through these incisions. If cancer is suspected, cyst testing may be performed. After cyst removal, the abdomen is deflated, and incisions are closed with dissolvable stitches and covered with dressing.


Recovery From A Laparoscopic Ovarian Cystectomy

If you have had a laparoscopic cystectomy, you may be able to go home the same day or you may need to stay one night in hospital.

Recovery from a laparoscopic cystectomy takes about one to three weeks. After this, you may be able to resume your usual activities, such as returning to work and doing light physical activities.


Can You Get Pregnant After A Laparoscopic Ovarian Cystectomy?

It should be possible for you to have children after having this procedure. However, if you have a condition such as endometriosis or polycystic ovary syndrome (PCOS), you may struggle to fall pregnant. This is because both conditions cause ovarian cysts and can also affect your fertility.


What Are The Benefits Of Having A Laparoscopic Ovarian Cystectomy?

The main advantage of having an ovarian cystectomy is that a potentially harmful or painful cyst is removed from your ovary. Removing an ovarian cyst can eliminate a few risks, including:

Reduced Cancer Risk

Ovarian cysts can be cancerous, especially when they develop after menopause.


Ruptured Ovarian Cysts

Cysts sometimes break open (rupture) and cause severe pain.


Ovarian Torsion

This occurs when the weight of the cyst causes the ovary to twist upon itself. This results in a lack of blood flow to your ovary and can lead you to lose your ovary completely. 


What Are The Risks Of Having A Laparoscopic Ovarian Cystectomy

Although this is a safe procedure, as with most surgical procedures, there are risks. If you had previous surgery on your pelvic organs, you may be at higher risk for complications. Other factors such as smoking, diabetes or obesity may also increase your risk of complications.

Some rare but potential complications include:

  • Infertility. If damage occurs to your ovary or fallopian tube during surgery, it may affect your ability to get pregnant.
  • Infection or irritation at the incision site
  • Injury to surrounding tissues or organs
  • Bleeding
  • Allergic reaction to anaesthesia
  • Blood clots
  • The cyst returns after surgery
  • Needing to remove one or both ovaries (oophorectomy).
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