OBJECTIVE:

To assess the feasibility and surgical outcome of laparoscopic surgery among women with huge benign ovarian cysts.

METHODS:

25 cases of huge ovarian cysts with maximum diameter more than 15 cm which were managed laparoscopically, were retrospectively studied from November 2014 to October 2016. Ultrasound, CT scan and tumor markers were done  to establish benign nature of the cyst. Ovarian cysts with preoperative suspicion of malignancy and huge dermoids were excluded from the study. Surgery performed included cystectomy, salpingo oophorectomy or lap hysterectomy depending on patient’s age and desire for future pregnancy.

RESULTS:

Twenty five patients underwent laparoscopic surgery over 2 years. The mean (range) age was 43.7 years (16–80 years)  Laparoscopic surgery was successful in 24 (96%) patients. The procedure was converted to laparotomy in 1 patient due to severe endometriosis and sigmoid adhesions. The mean (range) operative time, estimated blood loss and hospital stay for the laparoscopic procedures were  50 (45–120 min), 89 (20–100 mL) and 2(2–3 days), respectively. The surgical procedures performed were: unilateral or bilateral salpingo–oophorectomy , ovarian cystectomy and TLH with BSO. The cysts were extracted after decompression either through the vagina along with uterus or by umbilical incision. Pathologic findings included serous cystadenoma , mucinous cystadenoma , endometriosis , benign epithelial–lined cyst, cellular fibroma . There were no borderline or frankly malignant cysts in our study. The postoperative recovery was uneventful in all women.

CONCLUSION: With appropriate selection of cases and adequate surgical expertise, laparoscopy can be safely performed in huge benign ovarian cysts  with reduced morbidity and hence, should replace laparotomy in such cases.