Laparoscopic Ovarian Cystectomy/
Salpingo-Oophorectomy

Indication

   Ovarian cyst

The Procedure

   General anaesthesia

   Pneumoperitoneum created by insufflation of carbon dioxide

   Incisions made

   Telescope and instruments passed into abdomen

   Removal of ovarian cyst (Cystectomy) or removal of Fallopian tube and ovary (Salpingo-oophorectomy) done

   Specimen removed with zipper bag

   Frozen section to examine the specimen immediately can be done if necessary

   May need to remove specimen vaginally

   Abdominal (and vaginal) wounds closed

   Tissues removed will be sent for pathological examination or disposed of as appropriate unless otherwise specified

   Other associated procedures which may be necessary, such as blood transfusion

Photographic and / or video images may be recorded during the operation for education / research / documentation purpose. Please inform the staff if you have any objection.

Similarities with abdominal myomectomy

   Same pathology removed

   Same sequelae

Difference from abdominal myomectomy

   3-4 smaller abdominal wounds ± vaginal wound

   Less painful

   Faster postoperative recovery

   Earlier discharge, shorter sick leave required

Risk and Complication

   Risk of general anaesthesia

   Bleeding, may need blood transfusion

   Injury to neighbouring organs especially the bladder, ureters and bowels, may require repair

   Pelvic infection

   Wound complications including infection and hernia

Specific Complication

   Higher risk of rupture of cyst and spillage of its content

   Risk of laparotomy (less than 1% chance)

   May proceed to laparotomy if malignancy is confirmed, or may need a second surgery later

   Trauma to peritoneal organs and blood vessels

   May have dyspareunia following vaginal wound suturing

   Risk of incisional hernia with larger wounds

Risk of Not Having the Procedure

   May develop cyst complications such as torsion, bleeding, rupture

   Exact diagnosis cannot be ascertained and potential undiagnosed cancer

After the Procedure

   No effect on hormonal status in the presence of normal ovarian tissue

   Possible adverse effect on future fertility

   Risk of recurrence of the cyst, especially for endometriotic cyst

Alternative Treatment

   Laparoscopic cystectomy versus salpingo-oophorectomy

   Laparoscopic bilateral salpingo-oophorectomy

   Laparoscopic hysterectomy, bilateral salpingo-oophorectomy

   Open abdominal approach

Follow Up

   Consider hormonal therapy if both ovaries are removed

   Side effects include increased risk of breast cancer, deep vein thrombosis and gall stones

   Further treatment may be necessary in case of cancer

Remarks

The information contained is very general. The list of complications is not exhaustive and other unforeseen complications may occasionally occur. In special patient groups, the actual risk may be different. For further information, please contact your doctor.