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Laparoscopic guided mini-laparotomy. A novel technique for the management of benign large ovarian cysts: An interventional study
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  • Mohamed Shaltout,
  • Ahmed Maged,
  • Sherif Sameh Zaki,
  • Rana Abdella,
  • Mona Sediek,
  • Sherif Dahab,
  • Rasha Elkomy,
  • Moutaz Elsherbini
Mohamed Shaltout
Kasr Aini medical school
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Ahmed Maged
Kasr Aini medical school
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Sherif Sameh Zaki
Cairo University Kasr Alainy Faculty of Medicine
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Rana Abdella
Cairo University Kasr Alainy Faculty of Medicine
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Mona Sediek
Cairo University Kasr Alainy Faculty of Medicine
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Sherif Dahab
Cairo University Kasr Alainy Faculty of Medicine
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Rasha Elkomy
Cairo University Kasr Alainy Faculty of Medicine
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Moutaz Elsherbini
Cairo University Kasr Alainy Faculty of Medicine
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Abstract

Objective to evaluate the efficiency and safety of a novel technique to keep benefits of laparoscopic management in women with large ovarian benign cysts without affection of the ovarian reserve Design: An interventional study Setting: Kasr Alainy medical school, Cairo university hospital Population: 112 women with large benign ovarian cyst candidate for ovarian cystectomy. Methods: The technique started with laparoscopy followed by guided cyst aspiration followed by exteriorization of the ovary through minilaprotomy and completion of cystectomy through microsurgical technique. Main Outcome Measures: The primary outcome was ipsilateral recurrence of the cyst. Other outcomes included ovarian reserve assessment and postoperative pain. Results: The number of women with recurrence in the ipsilateral ovary after 12, 18 and 24 months were 5 (4.5%),16 (14.3%),20 (17.85%) respectively. Assessment of ovarian reserve revealed a significant decrease in the level of serum AMH (2.82±0.44 vs. 2.50±0.42) and a significant increase in AFC (3.5±1.7 vs. 4.9±1.3) after our novel technique in the surgical treatment of ovarian cysts (P-value <0.001). The operative time was 50±7 and 62±7 minutes in unilateral and bilateral cysts respectively. Conclusions: Laparoscopic guided minilaparotomy is a safe and effective technique for the management of large benign ovarian cysts with minimal recurrence rate, ovarian reserve affection, and adhesions.