title: [Giant ovarian cyst extraction by means of minilaparotomy: hourglass technique].
abstract: We report a case of a giant ovarian cyst and its removal by means of a newly and low morbid technique. It's about a 40 years-old female with intervascular closing cardiovascular surgery history, 25 years before, and one pregnancy and one delivery. She has two years development of middle effort dyspnea, weight gain and abdominal distension. Physical examination reveals a weight of 160 kg, 1.60 m of height, mild teguments paleness, and walkinf difficulty due to its grate distension; blood pressure was 150/70 mmHg, cardiac frequency of 95 bpm, I to II grade systolic murmur at the aortic focal accessory (in a I to VI scale), hypoventilated lung fields, grate abdominal distension, mild percussion pain, and low peristalsis. External genitals were normal, and wide vagina. Cervix of uterus was hardly seen due to its small size, without evident damage; nor uterus nor appendages can be delimited during vaginal touch. There was venous failure in lower limbs with ++ edema. An 8 cm supraumbilical minilaparotomy was performed, and 45 liters of citrin were aspired. When tumor tension decreases it was placed a Mayo table with sterile fields next to surgical table, and the abdomen was pulled laterally until tumor protrusion trough surgical incision, liquid weight puts tumor out of the abdomen. Cyst total weight was 55 kg, and hystopathological report was benign serous giant ovarian cyst.
  
  
  CONCLUSIONS
  Hourglass technique used in this report is simple, practical, and safe, requires a small incision and has lower morbidity in patients with high surgical risk.
authors.affiliation: Departamento de Ginecología y Obstetricia, Hospital San José ITESM Monterrey.
authors.forename: Jacobo
authors.initials: J
authors.lastname: Guajado Martínez
authors.forename: Juan de Dios
authors.initials: Jde D
authors.lastname: Maldonado Alvarado
authors.forename: Justo
authors.initials: J
authors.lastname: Cárdenas Ochoa
authors.forename: Enrique
authors.initials: E
authors.lastname: Saídivar Ornelas
authors.forename: Christian
authors.initials: C
authors.lastname: Villeda
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D010048:Ovarian Cysts / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed