Management of cystic ovarian masses by laparoscopic surgery: results of 275 cases

Objective To assess the results of operative laparoscopy in terms of operat ion time, postoperative care, histological diagnosis and complications. Design Retrospective evaluation of women who had undergone laparoscopic man agement of cystic ovarian masses. Setting Two Swedish university hospitals. Subjects 275 women with clinically and sonographically benign cystic ovaria n masses. Interventions Operative laparoscopy under general anaesthesia was carried o ut in all the women. Bipolar coagulation, suture loops, suction/irrigation and various cutting instruments were used. Main outcome measures and Results No major intraoperative complications occ urred in this series. Minor complications included injury of the inferior e pigastric artery, postoperative nausea, shoulder pain and temporary urine r etention. Three patients underwent a second surgical procedure because of p ostoperative intra-abdominal bleeding. The adnexal cystic masses varied in size from 2 to 12 cm (mean 5.5 cm). The mean total operation time was 54 mi n (range 15-200 min). The postoperative stay at the clinic ranged from 6 to 144 h (mean 23 h). Histopathological examination showed malignancy in 1.8% of the cases. Conclusions In this setting operative laparoscopy appears to be a safe and effective method for treating clinically and ultrasonographically benign ov arian cysts. Day surgery is possible in the majority of cases.