Laparoscopic excision of a large ovarian cyst

Excerpt

We present a case of laparoscopic drainage and excision of a large ovarian cyst. A 22-year-old, nulliparous woman presented to a general practitioner with occasional right-sided upper abdominal pain. An abdominal ultrasound was arranged to assess the biliary system. However, the scan identified a huge ovarian cyst filling the entire abdominal cavity from the epigastrium to the pouch of Douglas. An urgent review was arranged at the gynaecology clinic. There was generalized distension of the abdomen, but the margins of the cyst were not palpable. A repeat pelvic ultrasound scan was arranged in the gynaecological ultrasound department to examine the cyst in detail. It appeared simple in nature, with a unilocular fluid-filled cavity. The approximate size was 50 × 30 × 13 cm. No solid elements, ascites or renal system dilatation was noted on ultrasound. CA-125(15 iu/ml), CEA (2 ng/ml) and HCG (<5 iu/l) were all normal. After detailed discussion with the patient about the management options, a decision was made to perform laparoscopic drainage and excision of the cyst. The patient was aware of the possibility of oophrectomy and laparotomy if complications arose during the procedure or if it proved impossible to excise the cyst laparoscpically. …