Laparoscopic guided mini-laparotomy. A novel technique for the
management of benign large ovarian cysts: An interventional study
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.