Most ovarian cysts (functional cysts) resolve spontaneously over time, these are normally followed-up through serial pelvic ultrasound. However, other ovarian cysts such as dermoid cysts, endometriomas or large cystadenomas will require surgical excision, most commonly through laparoscopic (key-hole) surgery.
Ovarian cystectomy refers to the removal of an ovarian cyst while preserving the ovary, especially in women who desires fertility.
In some cases, removal of the entire ovary (oophorectomy) is recommended over the removal of the ovarian cyst:
In most cases, only one of the two ovaries is removed to preserve hormonal function, even in post-menopausal women. Each decision would be considered and tailored carefully to each individual woman.
Ovarian cysts of all sizes can be removed laparoscopically. The tumour (cyst) is removed from the surrounding normal ovarian tissue, and is then placed in a special bag for removal from the body via the key-hole incisions. This allows the procedure to be performed in a minimally invasive way, reducing the risks of an open surgery.
In many cases, laparoscopy replaces the need for open surgery (with larger cut in the abdomen), therefore:
Laparoscopic ovarian cystectomy should be performed by specialist gynaecologists who have completed additional training either in minimally invasive gynaecology surgery, or in surgical gynaecological oncology in order to learn techniques and procedures to complete the most complex surgeries with lower complication rates and quicker recovery period. They also perform higher volume of more complex cases.
Link to AGES Patient Information Video on Laparoscopic Ovarian Cystectomy.