Laparoscopic surgery for ovarian cysts is one of the most frequent lap
aroscopic surgical procedures performed presently. The routine use of
pelvic imaging (sonography), in the case of any gynaecological symptom
or as a screening method in women at risk, explains why more and more
ovarian cysts are encountered. The diagnostic and therapeutic challen
ge for the clinician to provide the best immediate and long-term benef
its for the patient is to identify pre-operatively not only an ovarian
malignancy (to be treated in a conventional way) but also functional
cysts (usually disappearing spontaneously and requiring no form of tre
atment in most cases). Ideally, only benign 'organic' cysts should be
treated laparoscopically. The technical aspects and the benefits of th
is approach have been documented extensively in recent years. The rout
ine use of the 'closed technique' and of an impermeable bag for remova
l should limit the risk of spillage of the cyst contents with its inhe
rent potential problems (chemical peritonitis, malignant cell dissemin
ation and parietal implantation into the laparoscopic port sites). The
adnexal torsion can be also properly managed by laparoscopic surgery.