Overview

Laparoscopic Ovarian Cystectomy is a minimally invasive surgical procedure used to remove ovarian cysts while preserving ovarian tissue. It is performed through small abdominal incisions.

Laparoscopic ovarian cystectomy is crucial for treating symptomatic ovarian cysts, preventing complications, and preserving fertility. It offers faster recovery compared to open surgery.

Learn more in our comprehensive RxDx OBG Course

Indications

✓
Symptomatic Ovarian Cysts

Pain, pressure symptoms

✓
Large Ovarian Cysts

>5-6 cm in diameter

✓
Complex Ovarian Cysts

Suspicious for malignancy

✓
Endometriomas

Endometriosis-related cysts

✓
Persistent Cysts

Cysts not resolving spontaneously

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Hemodynamic instability
✗ Suspected malignancy

Relative Contraindications

✗ Previous extensive surgery
✗ Severe adhesions
✗ Pregnancy

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient consent, preoperative antibiotics, positioning, equipment setup, and team briefing. All team members should understand their roles.

Step-by-Step Procedure

Step 1: Patient Preparation

Position patient, prep and drape, administer antibiotics.

⚠️ Common Mistakes to Avoid:

  • Poor positioning
  • Inadequate prep

💡 Pro Tip:

Position patient in lithotomy position.

Step 2: Pneumoperitoneum

Create pneumoperitoneum with CO2.

⚠️ Common Mistakes to Avoid:

  • Inadequate pressure
  • Gas embolism

💡 Pro Tip:

Use appropriate pressure (12-15 mmHg).

Step 3: Port Placement

Place laparoscopic ports strategically.

⚠️ Common Mistakes to Avoid:

  • Wrong port placement
  • Injury to vessels

💡 Pro Tip:

Place ports under direct vision.

Step 4: Exploration

Explore abdomen and identify cyst.

⚠️ Common Mistakes to Avoid:

  • Incomplete exploration
  • Missed pathology

💡 Pro Tip:

Explore all quadrants systematically.

Step 5: Cystectomy

Remove cyst while preserving ovary.

⚠️ Common Mistakes to Avoid:

  • Ovarian injury
  • Incomplete removal

💡 Pro Tip:

Use gentle dissection technique.

Step 6: Hemostasis

Ensure adequate hemostasis.

⚠️ Common Mistakes to Avoid:

  • Bleeding
  • Hematoma

💡 Pro Tip:

Use bipolar cautery for hemostasis.

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Post-procedure Care

Post-procedure care involves monitoring for complications, pain management, wound care, and early ambulation.

Complications & Management

Complication Incidence Signs Management Prevention
Bleeding 2-5% Hemodynamic instability Exploration, hemostasis Careful dissection
Ovarian injury 3-8% Reduced ovarian function Repair if possible Gentle technique
Infection 1-3% Fever, wound erythema Antibiotics Preoperative antibiotics
Port site hernia 1-2% Abdominal bulge Surgical repair Proper port closure

Clinical Pearls

💡

Use appropriate pneumoperitoneum pressure.

🎯

Place ports under direct vision.

⚡

Use gentle dissection technique.

🔍

Explore all quadrants systematically.

📊

Preserve ovarian tissue when possible.

🎨

Ensure adequate hemostasis.

⚠️

Monitor for complications post-operatively.