[Laparoscopic surgery of ovarian cysts. Indications and limits as found in a series of 169 cysts].
The new laparoscopic surgical techniques which have been adapted for treating ovarian cysts fulfil a double purpose; to reduce the need for traditional surgical treatment while at the same time being sure to remove the whole of the cyst wall. They make it possible in this way to avoid unnecessary laparotomies for many patients. They forestall recurrences of the cyst while at the same time lessening the risk of adhesion formation. We present a series of 169 adnexal masses of which 158 were treated successfully using these techniques. This experience has made it possible for us to work out an exact operative protocol for transparietal and intra-peritoneal cystectomies and for transparietal oophorectomies. All histological kinds of ovarian cysts that are benign can be treated laparoscopically, but endometriomas and dermoid cysts made it fail in 18.1% and 5.7% of cases respectively. Only in a few cases ultrasound guided punctures of the cysts could be carried out and that only in ovarian cysts with clear fluid in women of reproductive age. Apart from this limited group, from now on laparoscopy should be the treatment for most adnexal cystic masses. Laparoscopy is the only way after looking carefully at the whole of the pelvis, to work out whether it is possible to operate on them through the laparoscope and this now allows a varied attitude to treatment to be adapted and changing according to each case.
Hauuy
J P
JP
Hôpital Bichat, Paris.
Madelenat
P
P
Bouquet de La Jolinière
J
J
Dubuisson
J B
JB
D000293:Adolescent; D000328:Adult; D002648:Child; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D010048:Ovarian Cysts / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D014463:Ultrasonography
Chirurgie per-coelioscopique des kystes ovariens. Indications et limites à propos d'une série de 169 kystes.