【Gynecological Laparoscopy】Laparoscopic Ovarian Cyst Removal
Ovarian cyst is a relatively common female ovarian disease that requires surgical treatment. The traditional treatment of ovarian cysts is open surgery. With the development and innovation of endoscopic technology in recent years, laparoscopic non-open treatments have gradually become a better choice for patients with benign ovarian cysts. However, malignant lesions should be promptly converted to open surgery.
Laparoscopic ovarian cyst removal refers to the complete removal of ovarian cyst tissue through laparoscopy. Because this treatment method has less damage to the patient and can preserve the normal ovarian tissue as much as possible, it is widely used in the field of gynecology.
Surgical methods:
General anesthesia for tracheal intubation, the patient lies on his back with his head low buttock and high position. After the formation of pneumoperitoneum, first conduct a comprehensive exploration of the abdominal cavity, focusing on checking the size and mobility of the cyst and whether there is pelvic adhesions. For those with pelvic adhesions, separation of pelvic adhesions should be performed first. According to the specific conditions of the patient, such as age, reproductive history, nature and size of the cyst, select the appropriate ovarian cyst stripping procedure. For patients with larger cysts, first use a puncture method to suck out part of the cyst fluid with a suction device. After the cyst becomes smaller Then perform cystectomy, and then use bipolar electrocoagulation to fully stop bleeding on the ovarian wound. If the cyst ruptures, 1500～2000mL normal saline can be used to repeatedly flush the abdominal cavity to minimize the irritation of the cyst fluid to the peritoneum. Place the stripped cyst into the specimen collection bag and pull it out from the left side incision to take out the cyst specimen. For patients with infertility, tubal drainage can be performed at the same time during the operation. Finally, the CO2 gas in the abdominal cavity is completely evacuated, and the operation is over.
Laparoscopic treatment of ovarian cysts has the advantages of less trauma, less pain, high safety, good curative effect, quick recovery, etc. However, if the patient has the possibility of malignant ovarian disease, and it is difficult to eliminate 100% before surgery, treat the ovaries through laparoscopy Cysts may aggravate the spread and metastasis of tumor cells. This requires doctors to carefully check before performing laparoscopic surgery, ask for detailed medical history, carefully perform gynecological and ultrasound examinations and tumor marker detection on the patient, and perform frozen section of suspicious tumor specimens during the operation.
After the ovarian cyst is completely peeled off under laparoscopy, bipolar electrocoagulation should be used to stop bleeding on the peeled surface of the ovary in time. During this process, care should be taken to protect normal ovarian tissue to prevent endocrine function from being affected. For cysts that may be ruptured or difficult to peel, a suction device should be used to aspirate the cyst fluid through puncture, and then repeated intracystic lavage to expand the cyst wall to facilitate the exfoliation of the cyst and prevent the cyst fluid from contaminating the abdominal cavity.
