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Fast Leak-Proof, Intraumbilical, Single-Incision Laparoscopic Ovarian Cystectomy for Huge Ovarian Masses: "Hybrid Cystectomy and Reimplantation" Method

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Abstract
Background and Objectives: To introduce a new technique for fast leakage-proof, intraumbilical, single-incision laparoscopic ovarian cystectomy for huge ovarian masses (>10 cm) Materials and Methods: Seven consecutive, reproductive-aged women, including three adolescents, with huge ovarian masses (mature cystic teratoma, n = 4; endometrioma, n = 2; and mucinous cystadenoma, n = 1) who underwent transumbilical single-incision ovarian cystectomy with the new "hybrid cystectomy and reimplantation" method were included. The procedure was: (1) trans-umbilical single-incision laparoscopy; (2) inspection of the pelvic cavity and placing the mass in a laparoscopic endo-bag for cystic content leakage prevention; (3) in-bag resection using cold scissors and minimal cauterization of the cystectomy site; (4) in-bag tissue extraction; (5) rapid extracorporeal cystectomy with traction without electrocautery; (6) re-insertion of the retrieved ovarian cortex intracorporeally through the single port, and (7) intracorporeal suture of the retrieved tissue to the in situ ovary. Results: The mean patient age was 24.71 +/- 6.56 (range 17-37) years and the mean maximal diameter of the masses was 17.71 +/- 2.86 (range 13-22) cm. There was no case of unintended intracorporeal cyst rupture and no need for copious irrigation for washing and suctioning the leaked mass content. The mean total operating time was 76.42 +/- 6.39 (range 65-85) min, the total volume of saline used for irrigation was 814.28 +/- 331.35 (range 500-1500) mL, and the estimated blood loss was 107.14 +/- 47.72 (range 50-200) mL. There were no perioperative complications. All patients except the two endometriosis patients had regular, normal menstruation. Conclusions: Our preliminary findings were encouraging in terms of the safety and efficiency of the new method. Future trials need to elucidate the benefits of this method in terms of fertility preservation.
Author(s)
이사라
Issued Date
2021
Type
Article
Keyword
CystsFertilityhuge ovarian massLaboratoriesLaparoscopyLaparotomyMethodsOophorectomyovarian cystectomyOvariesPatientsPeritonitissingle-incision laparoscopic surgerySurgerySurgical techniquesSuturesTumorsWomens health
DOI
10.3390/medicina57070680
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7512
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_bf05c030598f4f6fa150e7b648fb6a36&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Fast%20Leak-Proof,%20Intraumbilical,%20Single-Incision%20Laparoscopic%20Ovarian%20Cystectomy%20for%20Huge%20Ovarian%20Masses:%20%26quot;Hybrid%20Cystectomy%20and%20Reimplantation%26quot;%20Method&offset=0&pcAvailability=true
Publisher
MEDICINA-LITHUANIA
Location
스위스
Language
영어
ISSN
1010-660X
Citation Volume
57
Citation Number
7
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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