Laparoscopic approach to dermoid cysts: combined surgical technique and ultrasonographic evaluation of residual functioning ovarian tissue.
OBJECTIVE
To estimate how and if laparoscopic removal of ovarian dermoid cysts is a tissue-sparing procedure.


METHODS
Prospective study (Canadian Task Force classification II-2).


METHODS
University-associated hospital.


METHODS
Fifty-five women.


METHODS
Laparoscopic removal of ovarian dermoid cysts by a combination of hydrodissection and blunt dissection, and transvaginal sonographic (TVS) evaluation of residual ovarian tissue.


RESULTS
Within 1 week before surgery all recruited patients underwent TVS evaluation of ovarian volume, size, and morphology of dermoid cysts and measurement of surrounding ovarian cortex. Mean cyst diameter was 5.5 +/- 2.2 cm (range 2.1-15.0 cm). Within 6 to 12 months after laparoscopic excision, TVS measurements of residual ovarian tissues were obtained. Ovarian residual cortex surrounding the cyst was not visible at TVS in 24 ovaries, whereas in 56 ovaries residual tissue volume was greater than 3 cm3 after laparoscopic excision.


CONCLUSIONS
We propose laparoscopic removal of dermoid cysts by combining hydrodissection and blunt dissection with maximum tissue sparing, even when the cyst seems to fill the ovary and no surrounding ovarian cortex can be seen on ultrasound.
Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Rome 00186, Italy.
Errico
E
Zupi
Caterina
C
Exacoustos
Beata
B
Szabolcs
Daniela
D
Marconi
Claudia
C
Carusotti
Marco
M
Sbracia
Domenico
D
Arduini
Giulio
G
Lanzi
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003884:Dermoid Cyst / Q000000981:diagnostic imaging* / Q000601:surgery*; D019160:Endosonography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D010053:Ovary / Q000473:pathology*; D011184:Postoperative Period; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome