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 UNUSUAL CASE
Year : 2011  |  Volume : 7  |  Issue : 4  |  Page : 232-235

Single incision laparoscopic surgery ovarian cystectomy in large benign ovarian cysts using conventional instruments


1 Department of Minimal Access Surgery and Gynaecology, Fortis Super Speciality Hospital, Mohali, Punjab; Department of General laparoscopic surgery, SGHS Hospital, Mohali, Punjab, India
2 Department of Minimal Access Surgery and Gynaecology, Fortis Super Speciality Hospital, Mohali, Punjab, India
3 Department of General Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
4 Department of School of Medicine, Simches Research Center, Massachusetts General Hospital, Boston, MA, USA

Correspondence Address:
Pankaj Garg
1042, Sector-15, Panchkula, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.85646

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We describe a technique for the management of large benign ovarian cysts by single incision laparoscopic surgery (SILS) through the umbilicus. The paucity of intra-abdominal working space in large ovarian cysts poses a technical challenge. Moreover, difficult convergence of operating instruments and competition for operating space outside the abdomen during the SILS makes the procedure quite demanding, especially with the conventional instruments. The concept of providing traction by taking sutures from the abdominal wall, as done in SILS laparoscopic cholecystectomy, was applied for SILS cystectomy in large ovarian cysts. Two sutures taken through the abdominal wall and then through the cyst wall provide excellent traction and "hang" the cyst from the abdominal wall, making it convenient to dissect and operate. This technique demonstrates that SILS ovarian cystectomy is feasible, safe and technically unchallenging even in large benign ovarian cysts.






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