title: A modified technique to reduce spillage and operative time: laparoscopic ovarian dermoid cyst enucleation 'in a bag'.
abstract: BACKGROUND
  To describe the outcomes of a modified technique for conservative laparoscopic enucleation of ovarian dermoid cyst, placing the ovary in an endobag during enucleation to prevent intraperitoneal spillage.
  
  
  METHODS
  Laparoscopic dermoid cyst enucleation was performed in 35 cases of premenopausal patients placing the ovary in an endobag at the beginning of the procedure and removing the cyst from the abdominal cavity by the same endobag.
  
  
  RESULTS
  Dermoid cysts with a mean diameter of 6.3 ± 2.7 cm were enucleated and removed laparoscopically 'in a bag' without intra- or postoperative complications. Cyst rupture occurred in 10 cases (28.5%), but evident peritoneal contamination occurred in only 2 (5.7%; 95% confidence interval: 0.7-19.2%), because in 8 patients spillage was contained by the surrounding bag. The mean operative time was 64.6 ± 27 min. No signs or symptoms of peritonitis were observed. The mean postoperative hospitalization was 1.6 ± 1.4 days. Among the 12 infertile patients, 7 spontaneous pregnancies (58%) occurred.
  
  
  CONCLUSIONS
  Laparoscopic conservative excision of dermoid cysts placing the ovary in an endobag at the beginning of surgery and removing the cyst by the same bag is a safe and effective approach to reduce intraperitoneal spillage and operative time.
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Campo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Campo
mesh_terms: D000293:Adolescent; D000328:Adult; D003884:Dermoid Cyst / Q000601:surgery*; D005260:Female; D005298:Fertility; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods*; D010048:Ovarian Cysts / Q000601:surgery*; D010053:Ovary / Q000601:surgery; D011183:Postoperative Complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D017697:Premenopause; D013048:Specimen Handling / Q000295:instrumentation*; D055815:Young Adult