A prospective, randomized comparison of port wound and culdotomy for extracting mature teratomas laparoscopically

Study Objective. To compare removing teratomas through a culdotomy opening or through an enlarged port wound. Design. Prospective, randomized trial (Canadian Task Force classification I ). Setting. Veterans Hospital. Patients. Thirty-one women with mature teratoma s identified by ultrasound examination and biochemical markers. Intervention. Laparoscopic cystectomy. Measurements and Main Results. Patients were randomly assigned to have the cysts removed intact in a cellulose bag through an enlarged port site (15, group A) or through a culdotomy opening (16, group B). Inclusion criteria w ere history of vaginal delivery, no previous abdominal surgery, no history of pelvic inflammatory disease, no medical illness, and no symptoms. Operat ing time in group B (90 +/- 18 min) was significantly longer than that in g roup A (70 +/- 22 min, p = 0.0113). Blood loss was 79 and 49 ml, respective ly (p = 0.0010). There was no significant differences in tumor size, patien t age, and postoperative recovery between groups. Conclusion. It is possible to remove intact ovarian dermoid cysts and preve nt rupture and spillage of cyst contents during laparoscopic surgery by bot h approaches. We prefer the enlarged port because operating time is shorter and blood loss is less.