Laparoscopic surgery for ovarian cysts
Ovarian cysts
are common, usually benign and sometimes self-limiting. For instance, functional
ovarian cysts can come and go during the normal ovarian cycle, while persistent cysts
can be associated with endometriosis (referred to as an
"endometrioma"). There are many other reasons why ovarian cysts develop,
however, and the diagnosis may only be clear once the cyst has been excised and checked
by a pathologist.
Surgical removal is usually advisable if a cyst persists, or is relatively large (> 5 cm), or is symptomatic (e.g. causing pelvic or lower abdominal pain), or its nature is unclear. Ultrasound scanning and blood tests (tumour markers such as CA-125) can help in assessing the likely nature of an ovarian cyst prior to surgery. The choice of procedure is between removing the cyst only (ovarian cystectomy) or the cyst with the affected ovary (oophorectomy), the best option depending on the clinical situation. Sometimes (e.g. if you are post-menopausal), it is reasonable to remove both ovaries even if only one is abnormal to avoid future problems in the remaining ovary. Laparoscopic bilateral oophorectomy is sometimes indicated in women with breast cancer.
Laparoscopic surgery for ovarian cysts is an established procedure, so in many cases the procedure can be done laparoscopically rather than by laparotomy. However, there are situations when laparotomy is the safest option.