Ovarioscopy and laparoscopic removal of a large right adnexal cyst.
Bottom Line: The combination of ovarioscopy and laparoscopy can be used to remove a large adnexal cyst.
The combination of ovarioscopy and laparoscopy can be used to remove a large adnexal cyst.
Related in: MedlinePlus
Mentions: The patient was taken to the operating room. General anesthesia was administered, and the patient was placed in the dorso-lithomy position in the Yellow-fin stirrups. Her abdomen was prepped in the standard fashion. Ovarioscopy was then performed. A 5-mm incision was made in the right lower quadrant, and a 5-mm trocar was inserted directly into the adnexal mass. A 5-mm scope was placed through this initial port to visualize the inside of the mass (Figure 2). The walls of the cyst were smooth and the fluid was clear. There were no septations or excrescences inside the cyst. Using the suction-irrigator, 3500 mL of fluid was removed completely deflating the mass. No fluid spilled into the peritoneal cavity. Laparoscopy was then performed. A Veress needle was inserted in the infra-umbilical area to insufflate the abdomen. A 5-mm trocar was inserted, and the exterior of the mass was visualized. A third port was made with a 5-mm trocar in the left lower quadrant under direct video visualization to continue the operative procedure. By using the “hair-roller” technique, the mass was rolled via an atraumatic grasper (Figure 3). The endoGia was used to resect the mass from the ovary (Figure 4). Thereafter, the mass was removed from the abdomen through the left lower quadrant port. There was minimal blood loss with this procedure. The left ovary and tube were normal by laparoscopic inspection with normal fimbriae. The residual right ovary and tube were normal.