Leak-proof puncture of ovarian cysts: Instant mounting of plastic bag using cyanoacrylate adhesive

Background: Reliable leak-proof aspiration of cyst contents is required for treatment of large ovarian cysts by minilaparotomy. Technique: Through a small abdominal wound a transparent plastic bag was in stantly mounted onto the cyst surface using an ethyl-2-cyanoacrylate adhesi ve. A l-P-cm-wide cut was made in the consolidated cyst wall through the in side of the bag and the contents directly aspirated. The fluid was trapped inside the bag without leaking into the abdominal cavity. This method can a lso be applied to relatively small cysts by holding the cyst just beneath t he wound. Experience: We used this method in 30 patients with unilateral ovarian cyst s and in one patient with an ovarian cyst associated with an ipsilateral pa raovarian cyst. All patients were successfully treated without spillage, al though in one case a large mucinous ovarian cyst ruptured before surgery. Conclusion: Minilaparotomy using the instant adhesive is cost-effective, sa fe, reliable, and easily implemented. This procedure is also applicable to relatively small cysts and is a viable alternative to laparoscopic surgery for treatment of dermoid cysts showing considerable calcification. (Obstet Gynecol 2001;97:1007-10. (C) 2001 by The American College of Obstetricians and Gynecologists.).