Laparoscopic guided minilaparotomy: a modified technique for management of benign large ovarian cysts

Mohamed F Shaltout, Ahmed M Maged, Rana Abdella, Mona M Sediek, Sherif Dahab, Moutaz M Elsherbini, Rasha O Elkomy, Sherif Sameh Zaki, Mohamed F Shaltout, Ahmed M Maged, Rana Abdella, Mona M Sediek, Sherif Dahab, Moutaz M Elsherbini, Rasha O Elkomy, Sherif Sameh Zaki

Abstract

Background: The aim of the study is to evaluate the efficiency and safety of a novel technique to treat large benign ovarian cysts combining benefits of laparoscopic management along with mini-laparotomy without affection of the ovarian reserve.

Methods: The study included 112 women with large benign ovarian cyst candidate for ovarian cystectomy. The technique started with laparoscopy followed by guided cyst aspiration followed by exteriorization of the ovary through minilaprotomy and completion of cystectomy through microsurgical technique. The primary outcome was ipsilateral recurrence of the cyst. Other outcomes included ovarian reserve assessment and postoperative pain.

Results: The number of women with recurrence in the ipsilateral ovary after 12, 18 and 24 months were 5 (4.5%),16 (14.3%),20 (17.85%) respectively. Assessment of ovarian reserve revealed a significant decrease in the level of serum AMH (2.82 ± 0.44 vs. 2.50 ± 0.42) and a significant increase in AFC (3.5 ± 1.7 vs. 4.9 ± 1.3) after our novel technique in surgical treatment of ovarian cysts (P value < 0.001). The operative time was 50 ± 7 and 62 ± 7 min in unilateral and bilateral cysts respectively.

Conclusions: Laparoscopic guided minilaparotomy is a safe and effective technique for the management of large benign ovarian cysts with minimal recurrence rate, ovarian reserve affection and adhesions.

Trial registration: clinical trial registry no. NCT03370952. Registered 13 December 2017, https://ichgcp.net/clinical-trials-registry/NCT03370952.

Keywords: Adhesion formation; Benign large ovarian cyst; Laparoscopy; Minilaparotomy; Ovarian reserve.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Consort flow of patients through the study
Fig. 2
Fig. 2
Extrusion of the cyst, Microsurgical cystectomy and ovarian closure

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Source: PubMed

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