| خلاصه مقاله | Title:
Laparoscopic Cystectomy
Fatemeh Tabatabaei
1) Department of Obstetrics and Gynecology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2) Department of Gynecologic Laparoscopic Surgeries, Women's Reproductive Health Research Center, Al-Zahra Hospital, Tabriz, Iran.
When surgery is indicated for benign ovarian disease, preservation of ovarian tissue via cystectomy or enucleation of a solid tumor from the ovary is generally preferable to complete oophorectomy. When the ovary cannot be salvaged or insufficient viable tissue remains after attempts at conservation, oophorectomy is usually performed. Aspiration of cyst contents is not recommended because no tissue is obtained for histopathology and cytology of cyst fluid is not reliable for exclusion of malignancy. Cystectomy is the preferred operation for a benign ovarian cyst. Most ovarian surgeries are for benign disease and can be performed via a minimally invasive surgical (MIS) approach. A disadvantage of an MIS oophorectomy/cystectomy is the potential for spill of cancer cells if the mass is malignant. The laparoscope is inserted periumbilically and other trocar sites are usually placed 5 to 6 cm laterally on either side. Then, the utero-ovarian ligament is grasped and the ovary stabilized. As with an open procedure, all adhesions should be lysed prior to beginning cyst removal. A cystotomy can then be performed, or if dissection around the cyst is possible, the cyst can be removed intact. The cyst may then be punctured with a 16- to 18-gauge needle or with cautery. Cystectomy is preferable to either cyst aspiration and fenestrations.
Key words: Cystectomy- Surgery- Benign- Laparoscopy. |