title: Laparoscopic excision of ovarian dermoid cysts with controlled intraoperative spillage. Safety and effectiveness.
abstract: OBJECTIVE
  To compare the operative and postoperative course in patients undergoing laparoscopy for dermoid cyst to that observed in subjects with other types of ovarian masses and of patients undergoing laparotomy for teratomas.
  
  
  METHODS
  Retrospective analysis. From 1994 to 1996, 49 women underwent laparoscopic cystectomy for dermoid cysts. The operative and postoperative course was compared to that of 190 patients undergoing operative laparoscopy for other adnexal masses and to that of 43 patients undergoing laparotomy for dermoid cysts from 1992 to 1996. The cysts were aspirated to reduce spillage and removed via a laparoscopic bag inserted in a 10-mm trocar. Culdotomy was never used. The abdominal cavity was abundantly flushed during the procedure and before closure.
  
  
  RESULTS
  Dermoid cystectomy was successfully performed laparoscopically in 47 of 49 cases. Spillage occurred in 43 cases (88%), and postoperative fever occurred in 3 (6.1%). No case of peritonitis was recorded. Significant differences between laparoscopy and laparotomy were observed in the rate of bilaterality (4% vs. 25%), spillage (88% vs. 9%) and mean hospital stay (37 vs. 83 hours). When laparoscopic excision of dermoid cysts and other masses was compared, we did not observe any significant difference in operative time or complication rates, apart from transient fever.
  
  
  CONCLUSIONS
  Laparoscopy is safe and effective for dermoid cysts and allows shorter hospitalization than laparotomy. As observed for other benign cysts, laparoscopy should become the technique of choice for the removal of most, if not all, ovarian dermoid cysts.
authors.affiliation: Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milan, Monza, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Zanetta
authors.forename: L
authors.initials: L
authors.lastname: Ferrari
authors.forename: M
authors.initials: M
authors.lastname: Mignini-Renzini
authors.forename: M
authors.initials: M
authors.lastname: Vignali
authors.forename: R
authors.initials: R
authors.lastname: Fadini
mesh_terms: D000328:Adult; D020420:Cyst Fluid; D005260:Female; D005334:Fever; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D010048:Ovarian Cysts / Q000150:complications / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000601:surgery; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013396:Suction; D013724:Teratoma / Q000601:surgery